LIBRARY 

OF  THE 

UNIVERSITY  OF  CALIFORNIA. 


BIOLOGY 

Class  LIBRARY 

G 


MARRIAGE  AND  DISEASE. 


MARRIAGE  AND  DISEASE. 

A  STUDY  OF 

HEREDITY  AND  THE  MOPE  IMPORTANT 
FAMILY  DEGENERATIONS. 


BY 


S.  A.  K.  STRAHAN,  M.D. 

BARRISTER-AT-LAW, 

MEMBER  OF  THE  HONOURABLE  SOCIETY  OF  THE  MIDDLE  TEMPLE,  LONDON 
MEMBER  OF  THE  COUNCIL  OF  THE  MEDICO-PSYCHOLOGICAL 

ASSOCIATION  OF  GREAT  BRITAIN  AND  IRELAND  ; 

MEMBER  OF  THE  MEDICO-LEGAL  SOCIETY  OF  NEW  YORK, 

MEMBRK  DE  L'UNION  INTERNATIONALE  DE  DROIT  PENAL,  ETC.  ETC. 


"There  is  a  destiny  made  for  a  man  by  his  ancestors,  and  no  one 
can  elude  the  tyranny  of  his  organisation."—  MAUDSLEY. 


NEW  YORK 
D. APPLETON  AND  COMPANY 

1892 


BIOLOGY 

LIBRARY 

G 


Authorized  Edition. 


I  DEDICATE 

TTbis  Boofe 

TO 

MY    FATHER    AND    MOTHER, 

FROM  WHOM  I  INHERITED 

ALL  THAT   I   POSSESS, 
PHYSICAL,   MORAL,   AND   INTELLECTUAL. 


194735 


CONTENTS. 


PAGE 

INTRODUCTORY I 

CHAP. 

I.   HEREDITY IO 

II.   VARIATIONS ,  .  .24 

III.  ACQUIRED   CHARACTERS 33 

IV.  REVERS.ON 44 

V.    PREPOTENCY   IN   CHARACTERS 56 

VI.   THE   LAWS   OF   HEREDITY    .           .           .           .  67 

VII.    HEREDITY   IN   INSANITY 8 1 

VIII.   MARRIAGE  AND   INSANITY 96 

IX.   MARRIAGE   AND   DRUNKENNESS Il6 

X.   MARRIAGE   AND   EPILEPSY 130 

XL    SYPHILIS 143 

XII.   DEAF-MUTISM ,           ,           .  l6l 

XIII.  CANCER 175 

XIV.  TUBERCULAR  DISEASE IQ4 

XV.   GOUT 214 

XVI.    RHEUMATISM 228 

XVII.    EARLY     MARRIAGES  I      THEIR     EFFECT      UPON     THE 

CHILDREN   ....                       ...  243 


viii  CONTENTS. 

CHAP.  .  PACK 

XVIII.    LATE      MARRIAGES  :       THEIR      EFFECT      UPON      THE 

CHILDREN 256 

XIX.    CONSANGUINEOUS   MARRIAGES 266 

XX.    INSTINCTIVE   CRIMINALITY 280 

XXI.    SOME   OF  THE   LESS   IMPORTANT   HEREDITARY  AFFEC- 
TIONS    301 


MABBIAGE   AND   DISEASE. 


INTRODUCTORY. 

THE  doctrine  of  the  hereditary  transmission  of  family 
characters,  pathological  as  well  as  physiological,  although 
now  incontestably  established,  has  by  no  means  been 
accorded  the  general  recognition  its  great  importance 
so  clearly  demands.  With  our  present  knowledge, 
there  cannot  be  the  very  slightest  doubt  in  the  mind 
of  any  one  who  has  even  casually  considered  the  sub- 
ject, that  much  of  the  disease,  both  physical  and  mental, 
which  afflicts  this  and  every  other  civilised  people  on 
the  face  of  the  earth  is  to  a  large  extent  the  result 
of  hereditary  transmission  of  a  degenerate  constitu-^ 
tion  or  predisposition  to  disease,  brought  about  by  the 
deteriorating  influences  of  civilised  life.  Nor  can  it  be 
doubted  that  the  tendency  of  the  age  is  toward  the 
cultivation  and  spread  of  these  hereditary  diseases; 
for  while  our  modern,  exciting,  feverish,  highly  artifi- 
cial, mode  of  life  is  prolific  of  disease  and  degenera- 
tive changes  in  the  organism,  the  customs  of  civilised 
society,  as  at  present  constituted,  are  designed  to  bar 


2  MARRIAGE  AND  DISEASE. 

the  course  of  Nature,  and  prevent,  so  far  as  is  possible, 
the  operation  of  those  laws  which  weed  out  and  exter- 
minate the  abnormal,  diseased,  and  otherwise  unfit  in 
every  grade  of  natural  life. 

The  beneficial  working  of  these  natural  laws  is  to 
be  seen  among  savage  and  less  civilised  peoples,  where 
the  mode  of  life  is  less  artificial  than  our  own — that 
is,  where  the  animal  is  in  more  perfect  accord  with 
his  environment  than  is  the  case  among  the  more 
highly  civilised  communities.  Even  here  we  find  the 
unfit ;  for  the  unfit  is  a  variation,  a  pathological  varia- 
tion, and  variations  both  pathological  and  physiological 
must  of  necessity  at  times  appear,  even  under  the 
most  favourable,  conditions.  But  when  such  variations 
from  the  normal  or  healthy  type  do  appear  in  natural 
life,  their  survival  is  of  brief  duration.  Here,  there 
is  no  continuance  of  the  deformed,  the  crippled,  and 
the  feeble.  Natural  selection  remorselessly  weeds  out 
all  individuals  who  from  any  cause  are  unfitted  to 
their  natural  environment,  and  it  is  this  law  which 
maintains  the  high  standard  of  health  which  exists 
among  all  savage  and  semi-civilised  races. 

How  different  is  this  from  what  obtains  in  the 
highly  artificial  life  which  civilised  man  has  built  up 
or  created  for  himself !  Here  the  weakling,  the  cripple, 
and  the  diseased,  who  in  the  natural  life  would  at  once 
succumb,  are  nursed  and  protected ;  they  are  surrounded 
with  an  artificial  environment  designed  to  render  a 
continuance  of  life  possible,  and,  finally,  if  they  be 
endowed  -with  the  procreative  function,  they  are  per- 


INTRODUCTORY.  3 

mitted  to  call  into  existence  a  wretched  offspring. 
In  this  way  we  make  an  attempt  to  hold  Nature  at 
bay.  We  fight  and  struggle  with  all  our  strength 
against  the  inexorable  law  which  condemns  the  unfit 
to  extinction.  Fortunately  for  the  race,  our  success,  our 
greatest  success,  can  only  be  temporary.  At  best  we 
can  only  for  a  little  time  put  off  the  evil  day,  if  it  can 
be  called  evil,  and  where  in  the  end  is  our  gain  ?  In 
the  more  primitive  and  natural  conditions  of  life,  the 
weakling  is  at  once  removed,  because  of  his  inherent 
weakness,  his  unfitness,  his  inability  to  suit  himself 
to  his  surroundings ;  whereas  we,  in  our  wisdom,  en- 
deavour to  postpone  that  consummation,  and  it  is  not 
until  one,  two,  or"  perhaps  three  generations  of  suffer- 
ing wastrels  have  fretted  and  wept  their  hour  upon 
the  stage,  that  we  stand  aside,  unable  longer  to  bar 
the  path,  and  see  Nature  do  her  work. 

I  do  not  for  a  moment  intend  to  question  the 
righteousness  of  these  endeavours  of  civilised  man  on 
behalf  of  his  afflicted  brother.  With  that  great  ques- 
tion we  have  nothing  here  to  do ;  we  can  but  admire 
the  beauty  of  the  unselfish  and  Christian  spirit  which 
prompts  his  action,  and  regret  that  Nature  vouchsafes 
him  such  a  sorry  reward.  Our  business  on  this  occa- 
sion is  of  a  far  more  practical  character  than  the 
consideration  of  such  vexed  questions.  It  is  to  tell 
those  whom  it  may  concern — and  it  concerns  the  whole 
race — that  disease  is  being  handed  down  from  father 
to  son,  from  mother  to  daughter,  from  parent  to  child ; 
to  point  out  how  all- important  to  the  ^ace,  how 


4  MARRIAGE  AND  DISEASE. 

inexorable  and  unescapable  is  this  law  of  hereditary 
transmission  of  disease,  or  of  liability  thereto. 

Sir  James  Paget  has  said,  "  If  one  could  set  before 
one's  self  the  gravest  and  most  important  problem  in 
all  pathology,  it  would  be  that  which  concerns  the 
inheritance  of  disease;  and,  as  Sir  William  Gull  has 
rightly  stated,  the  inheritance  not  of  disease  alone, 
but  of  that  which  from  generation  to  generation  shall 
obliterate  the  disease  which  one  ancestor  may  have 
acquired."  *  This  is  undoubtedly  true,  and  until  this 
most  important  problem  is  more  deeply  studied  and 
more  clearly  understood,  it  is  certain  that  the  physician 
will  not  be  able  to  exercise  to  the  full  his  highest  func- 
tion, which  is  not  to  cure,  but  to  prevent  disease. 

At  present  the  public  appear  to  know  little  of  this 
law  of  hereditary  transmission  as  applicable  to  them- 
selves, or,  if  they  know  it,  they  ignore  it.  For  while 
we  are  most  careful  not  to  transgress  this  law  of 
Nature  in  the  breeding  of  our  horses  and  cattle,  and 
even  our  dogs  and  cats,  few  of  us  appear  to  give  a 
moment's  thought  as  to  what  may  be  the  physical, 
moral,  or  mental  inheritance  of  our  children.  This 
disregard  must  arise  from  either  ignorance  or  careless- 
ness, and  it  is  the  duty  of  the  physician  to  make  it 
impossible  for  any  man  to  plead  the  former.  Surely 
in  these  days  of  almost  free  education,  when  the 
elements  of  physiology  are  taught  in  every  school,  it 
should  not  be  difficult  to  impress  upon  the  minds  of 
boys  and  girls  the  fact  that  this  law  of  hereditary 
*  Address  on  Collective  Investigation  of  Disease. 


INTRODUCTORY.  5 

transmission  applies  to  all  Nature's  creatures,  to  the 
highest  as  to  the  lowest,  to  man  as  surely  as  to  the 
inferior  animals.  Young  men  and  women  should  he 
told  of  those  diseased  conditions,  as  insanity,  epilepsy, 
scrofula,  drunkenness,  which  are  more  certainly  trans- 
mitted from  parent  to  child,  and  be  impressed  with 
a  lively  sense  of  the  terrible  responsibility  resting 
upon  those  who,  themselves  bearing  such  brand  of 
unfitness,  continue  their  kind,  bringing  immense  suffer- 
ing upon  the  earth,  which  would  never  have  existed 
had  they  exercised  discretion  and  self-denial. 

When  this  is  done,  when  men  and  women  can  no 
longer  plead  ignorance,  and  are  able  to  appreciate  even 
in  part  the  gravity  of  these  questions,  it  is  surely  not 
too  much  to  hope  that  some  at  least  will  pause  before 
calling  into  existence  creatures  foredoomed  to  sorrow 
and  suffering  and  ultimate  extinction. 

I  grant  that  most  attempts  at  interfering  with  the 
instincts  of  man  have  proved  futile.  In  these  matters 
passion  and  desire  are  permitted  to  dominate  reason  in 
the  vast  majority  of  cases ;  but  that  is  no  reason  or 
excuse  for  silence.  The  truth  concerning  the  tremen- 
dous issues  at  stake  should  be  proclaimed,  though  we 
know  the  great  many,  will  ignore  our  most  earnest 
warnings.  The  duty  of  the  teacher,  which  is  to  instruct 
and  forewarn,  is  not  the  less  clear  because  of  the  un- 
willingness of  the  people  to  hearken  to  the  truth.  I 
have  been  told  that  teaching  upon  this  subject  must 
prove  absolutely  fruitless;  that  men  and  women  will 
be  led  by  their  instincts  in  the  selection  of  husbands 


6  MARRIAGE  AND  DISEASE. 

and  wives,  and  will  refuse  to  be  guided  in  any  degree 
by  the  teaching  of  the  physiologist ;  but  this,  which, 
even  if  true,  is  no  argument  against  teaching  the  truth, 
I  decline  to  believe,  for  the  simple  reason  that  I  have 
known  good  and  honourable  men  and  women  who, 
aware  of  some  grave  hereditary  tendency  to  disease 
within  themselves,  have  voluntarily  abjured  marriage 
and  let  their  grievous  legacy  die  with  them.  The 
case  is  not,  therefore,  without  hope,  and  I  cannot  but 
believe  that  there  are  many  thinking  men  and  women 
who,  if  they  only  understood  what  a  terrible  heritage 
their  children  must  take  with  their  breath  of  life, 
would  cheerfully  accept  the  inevitable,  and,  renouncing 
all  the  pleasures  and  pride  of  the  matrimonial  state 
and  paternity,  let  their  miserable  estate  lapse  at  their 
death  for  want  of  an  heir. 

I  do  not  believe  in  the  generally  accepted  cry  that 
men  and  women  are  blindly  led  by  their  instincts  in 
these  matters.  The  matches  made  every  day  disprove 
it.  Love  is  not,  after  all,  so  overpowering  a  passion 
that  it  cannot  be  guided  by  reason,  nor  is  Cupid  so 
blind  as  he  is  painted.  For  rank  or  wealth  a  man 
will  woo,  a  woman  give  her  heart,  or  at  least  her 
hand ;  and  this  being  so,  surely  where  the  reward 
is  so  infinitely  greater,  where  the  whole  future  of  the 
coming  generation  is  at  stake,  rational  people  will  not 
permit  their  passions  to  run  riot  and  overbear  their 
reason. 

But  besides  these  extreme  cases  in  which  the 
hereditary  taint,  the  predisposition  to  disease,  is  so 


INTRODUCTORY.  ^ 

decided  that  marriage  should  not  be  thought  of,  there 
is  the  still  larger  class  of  those  in  whom  the  taint  is 
so  mitigated,  that,  with  a  properly  selected  partner,  a 
fairly  healthy  family  might  be  reared,  and  to  this  very 
large  class  instruction  is  of  the  utmost  importance. 
These  must  be  taught  that  their  only  safety  depends 
upon  their  selection  of  partners,  and  that  it  is  only  by 
strict  attention  to  this  that  those  bearing  within  their 
nature  the  germ  of  hereditary  disease,  or  tendency 
thereto,  can  hope  to  be  represented  in  remote  posterity. 
If  such  a  tainted  one  choose  a  partner  from  a  family 
free  from  his  own  taint,  or,  better  still,  free  from  any 
marked  hereditary  taint,  all  may  be  well;  but  if  he 
marry  a  person  having  the  same  abnormal  bent,  belong- 
ing to  the  same  distorted  offshoot  from  the  normal 
stem  to  which  he  himself  belongs,  then  disaster  will 
surely  fall  upon  the  luckless  children  called  into  being. 
It  is  a  question  how  far  the  present  evil  state  of 
things  should  be  allowed  to  go  before  the  strong  arm 
of  the  law  should  interfere.  At  present,  save  only  the 
idiot  and  the  raving  maniac,  who  are  in  the  eye  of  the 
law  unable  to  make  a  contract  binding  on  themselves, 
there  is  no  one  so  diseased,  crippled,  or  deformed  that 
he  or  she  may  not  marry,  and  become  the  parent  of  a 
suffering,  helpless  family,  so  far  as  the  law  is  concerned. 
Even  if,  during  a  "  lucid  interval,"  a  lunatic  contracts 
a  marriage,  it  is  valid,  unless  at  the  time  there  happens 
to  exist  an  unrevoked  commission  of  lunacy.  Can  any 
one  assert  that  this  state  of  things  is  for  the  good  of 
the  commonwealth  ? 


8  MARRIAGE  AND  DISEASE. 

Many  high  authorities  have  expressed  the  opinion 
that  those  suffering  under  gross  hereditary  disease,  or 
tendency  thereto,  should  not  be  permitted  to  continue 
their  like,  and  so  contaminate  the  race,  but  I  'fear  the 
day  for  such  legislation  has  not  yet  come.  Moreover, 
I  think  it  only  fair  to  assume  that  much  of  the  present 
continuance  of  transmitted  disease  is  the  result  of 
ignorance  on  the  part  of  the  people,  and,  on  this 
assumption,  some  effort  should  be  made  to  educate 
them  to  a  knowledge  of  how  terribly  relentless  and 
.unavoidable  is  this  law  of  Nature,  before  calling  upon 
the  Legislature  to  interfere  in  what  might  be  so 
much  better  done  by  public  opinion  and  individual 
effort. 

Much  might  also  be  done  by  pointing  out  how  some 
of  these  tainted  constitutions  may  be  acquired  de  novo ; 
how  the  man  or  woman  whose  family  has  a  clean  bill 
of  health  can  by  wicked  and  vicious  habits  build  up 
insanity,  or  epilepsy,  or  phthisis,  or  gout,  etc.,  to  be 
handed  down  to  posterity,  and  how  other  diseases  may 
be  acquired  which  shall  have  a  terrible  effect  upon 
children  afterwards  begotten.  It  should  also  be  taught 
how  a  man  or  woman  with  a  bad  family  history  may, 
by  a  steady  and  virtuous  life,  a  strict  observance  of  the 
laws  of  health,  and  proper  care  in  the  selection  of  a 
partner,  live  down  the  evil,  so  to  speak,  and  leave 
an  unencumbered  estate  to  the  children  of  the  next 
generation. 

When  these  things  have  been  taught  and  found 
ineffectual,  but  not  till  then,  should  the  Legislature  be 


INTRODUCTORY.  9 

called  upon  to  interfere,  except  in  those  cases  in  which 
the  drunkenness,  disease,  or  crime  is  so, ingrained  in 
the  nature  of  the  individual  that  no  amount  of  care 
or  forethought  could  be  expected  to  give  the  children 
what  might  be  called  "  a  reasonable  chance."  Among 
these  latter  would  be  included  imbeciles,  confirmed 
epileptics  and  drunkards,  those  who  have  been  insane 
more  than  once,  and  habitual  criminals,  all  of  whom 
should  be  at  once  denied  the  right  of  procreation. 


CHAPTER  I. 

HEREDITY. 

HEREDITY  is  that  mysterious  influence  which  fore- 
ordains that  the  offspring  shall  be  in  the  likeness  of  its 
parents.  It  is  one  of  Nature's  great  fundamental  laws, 
and  it  is  universal.  In  the  meanest  forms  of  animal 
and  vegetable  life,  as  in  the  highest,  each  family  must 
produce  its  like.  Grapes  are  not  gathered  from  thorns, 
nor  figs  from  thistles.  All  through  Nature,  from  the 
amoeba  to  man,  from  the  yeast-plant  to  the  oak,  every 
kind  produces  after  his  kind.  Yet  plants  and  animals 
are  not  tied  down  by  this  law  to  endless  sameness. 
Certainly  Nature  will  not  permit  any  rude  violation 
of  this  law  of  hereditary  transmission,  but,  where  the 
change  is  sufficiently  gradual,  where  it  is,  so  to  speak, 
the  work  of  Nature  herself,  it  is  with  the  aid  of  this 
very  law  that  modifications  are  built  up,  the  changes 
brought  about  in  the  individual  by  the  action  of  the 
environment  being  repeated  and  perpetuated  in  the 
offspring  by  the  action  of  the  laws  of  heredity.  These 
modifications  sometimes  tend  toward  the  elevation  of 
the  family  type — evolution,  and  sometimes  toward  its 
ex  tinction — dissolution. 


HEREDITY.  II 

The  influence  of  this  natural  law  begins  with  life 
and  only  ends  with  death.  The  life  of  the  individual 
begins  when  a  single  cell  from  the  male  (the  sperm) 
meets  with  a  single  cell  from  the  female  (the  ovum), 
and  this  combination  calls  into  being  a  new  creature. 
From  this  instant  heredity  is  at  work.  That  the  new 
creature  thus  produced  should  invariably  grow  up  in 
the  gross  and  outward  likeness  of  its  parents  is  as 
strange  as  it  is  at  present  inexplicable.  But  what  is 
still  more  wonderful  is  the  fact  that  these  two  germ- 
cells,  these  two  microscopic  masses  of  apparently  homo- 
geneous protoplasm,  which  convey  from  parents  to 
offspring  the  racial  peculiarities  of  tj^e  parents,  have 
the  further  power  of  transmitting  to  the  children  the 
various  individual  peculiarities  of  the  parents,  as  length 
of  limb,  colour  of  hair,  cast  of  features,  Nor  does 
the  marvellous  stop  even  here,  for  these  potent  atoms 
almost  invariably  convey  to  the  offspring,  as  seen  in 
the  human  family,  such  infinitely  complex  and  subtle 
similarities  as  trick  of  gait,  tone  of  voice,  longevity, 
liability  to  certain  diseases  and  immunity  against  others, 
together  with  mental  qualities,  and  even  moral  bent. 

The  child  takes  his  life  from  his  parents,  and  with 
that  life  he  takes  a  certain  estate  made  up  of  moral, 
mental,  and  physical  characters.  This  estate  must  be 
entered  upon  however  encumbered;  he  is  the  heres 
nccessarius  of  his  parents ;  he  cannot  renounce  his  claim 
upon  this  estate  and  let  it  pass  on  to  some  other  heir, 
neither  can  he  alienate  his  life-interest  therein.  He 
takes  it  with  his  life,  and  only  with  his  death  does  his 


12  MARRIAGE  AND  DISEASE. 

interest  in  it  lapse.  Of  what  vast  importance  is  it, 
then,  that  this  estate  should  come  to  the  child  "  free 
from  waste  and  dilapidation ; "  yet  how  often  it  proves 
a  veritable  hereditas  damnosa  we  have  but  to  look 
around  to  learn. 

As  might  be  expected,  many  attempts  have  been 
made  by  science  to  explain  this  wonderful  law  which 
governs  the  growth  and  development  of  germ-cells,  and 
enables  them  to  convey  not  only  the  gross  racial  traits, 
but  the  most  minute  and  subtle  individual  characters 
from  parent  to  offspring;  yet,  although  some  of  the 
greatest  minds  of  our  age  have  wrestled  with  the  sub- 
ject, no  one  has  Broken  the  secret-house.  Darwin  ela- 
borated the  hypothesis  which  he  called  "  Pangenesis  " 
to  explain  how  the  germ-cells  gained  this  extraordi- 
nary power.  He  supposed  that  minute  bodies,  which 
he  called  "  gemmules,"  were  thrown  off  by  all  the  cells 
of  the  body  and  congregated  in  these  germinal  cells. 
These  gemmules,  it  was  supposed,  had  the  power  of 
reproducing  cells  similar  to  those  from  which  they 
came,  and  so  the  germ-cells  were  enabled  through 
these  gemmules  to  produce  a  body  complex  and  iden- 
tical in  every  particular  with  those  from  which  the 
germ-cells  came.  But,  unfortunately  for  science,  this 
is  but  theory;  of  these  potent  gemmules  we  know 
nothing ;  they  have  not  even  been  proved  to  exist.  All 
we  have  is  the  ingenious  effort  of  a  great  mind  to 
fathom  what  at  present  seems  to  be  the  unfathomable. 

Nor  has  any  other  searcher  discovered  more.  Herbert 
Spencer's  "physiological  units"  and  Hackel's  "mole- 


HEREDITY.  13 

cular  motion  in  cells  "  are  equally  hypothetical ;  while 
nothing  is  really  known  as  to  the  action  of  Weis- 
mann's  "  germ-plasm  "  or  Nageli's  "  idioplasm."  We 
have  no  evidence  that  the  protoplasm  of  the  repro- 
ductive cell  differs  from  that  of  any  other  cell ;  yet 
that  it  has  the  power  of  transmitting  from  parent  to 
offspring  most  subtle  peculiarity  of  mind  and  body  we 
know  from  experience,  but  how  or  why  it  should  be 
so  endowed  still  remains  one  of  Nature's  profoundest 
secrets. 

Notwithstanding  the  fact,  however,  that  we  cannot 
follow  Nature  in  all  her  mysterious  workings,  our  course 
is  perfectly  clear.  We  know  that  "  like  produces  like  " 
all  through  Nature,  and  it  is  our  duty  to  recognise  the 
potent  influence  exerted  by  this  law  in  determining 
the  conformation  of  mind  and  body  in  the  human 
family,  and  endeavour  to  use  this  knowledge  for  the 
benefit  of  the  race.  The  hereditary  transmission  of 
physical  characters  has  been  known  from  the  earliest 
times  of  which  we  have  any  record,  and  man  has 
benefited  by  this  knowledge  in  the  breeding  of  animals 
from  time  immemorial.  (He  has  not  hesitated  to  apply 
it  even  to  the  human  family  when  the  excellence  of 
the  offspring  was  of  pecuniary  interest  to  him,  as  in 
the  case  of  slaves.)  Yet,  for  some  inscrutable  reason, 
when  it  becomes  a  personal  question  he  ignores  this 
great  fundamental  law,  and  every  year  thousands  of 
children  are  begotten  with  pedigrees  which  would  con- 
demn puppies  to  the  horsepond. 

What,  I  would  ask,  would  be  thought  of  the  man 


14  MARRIAGE  AND  DISEASE, 

who  proposed  to  increase  his  flock  or  herd  from  animals 
whose  ancestors  had  suffered  or  died  one  after  another 
from  some  common  disease  ?  Who  is  he  who  does  not 
choose  his  finest  animals  for  breeding  purposes,  and  if 
an  otherwise  superior  animal  have  a  fault,  endeavour 
by  judicious  "  crossing"  to  lessen,  and  in  time  eradicate, 
that  fault  ?  But  while  we  thus  study  with  jealous  care 
what  shall  be  the  natural  inheritance  of  our  horses, 
cattle,  and  hounds,  we  give  not  a  passing  thought  as 
to  what  may  be  that  of  our  children.  Animal  passion, 
sickly  sentiment,  or  the  desire  for  rank  or  wealth,  is 
permitted  to  jostle  aside  our  reason,  and  even  some  of 
us  whose  business  in  life  it  is  to  improve  the  breed  of 
some  useful  animal  by  careful  selection  may  be  found 
at  the  same  time  rearing  a  family  of  children  from  a 
mother  who  is  a  member  of  a  family  saturated  with 
disease.  While  we  practically  ignore  this  law  in  rela- 
tion to  the  human  family,  we  assuredly  never  forget  its 
great  influence  in  the  case  of  the  beasts  that  perish. 
Why  ?  Is  not  man  worth  more  than  many  brutes  ? 

Of  this  refusal,  this  obstinate  refusal  on  the  part  of 
man  to  recognise  the  effect  of  this  law  of  hereditary 
transmission  upon  the  human  family,  Dr.  Maudsley 
observes:  "Because  it  has  been  the  fashion  to  look 
upon  an  individual  as  if  he  were  the  product  of  an 
independent  creative  act  and  a  self -sufficient  being — 
because  men  commonly  look  not  beyond  a  single  link 
in  the  chain  of  causation — therefore  it  has  been  impos- 
sible hitherto  to  uproot  the  erroneous  notion,  explicitly 
declared  or  implicitly  held,  that  each  one  is  endowed 


HEREDITY.  15 

by  Nature  with  a  certain  fixed  mental  potentiality  of 
uniform  character.  But  now  that  observation  reveals 
more  and  more  clearly  every  day  how  much  the  capacity 
and  character,  mental  and  bodily,  of  the  individual  is 
dependent  upon  his  ancestral  antecedents,  it  is  impos- 
sible to  deny  that  a  man  may  suffer  irremediable  ill 
through  the  misfortune  of  a  bad  descent.  Each  one  is 
a  link  in  the  chain  of  organic  beings,  a  physical  con- 
sequent of  physical  antecedents;  the  idiot  is  not  an 
accident,  nor  the  irreclaimable  criminal  an  unaccount- 
able causality."  * 

As  I  have  said  before,  men  and  women  must  be 
made  to  understand  that  this  law  of  hereditary  trans- 
mission of  health  and  disease,  both  mental  and  physical, 
applies  equally  to  all  Nature's  creatures,  and  that  if  the 
race  is  to  be  improved,  it  must  be  done  on  exactly  the 
same  lines  as  are  followed  in  the  world  of  inferior 
animals,  viz.,  to  cultivate  the  good,  modify  and  improve 
the  indifferent,  and  let  the  absolutely  bad  die  out. 
"Like  father,  like  son,"  is  an  old  saying  and  a  true 
one.  Heredity  is  a  law  from  which  there  is  no  escap- 
ing. Our  bodily  and  mental  development,  as  received 
from  our  ancestors  and  modified  for  better  or  worse 
by  ourselves,  is  a  certain  heritage  for  our  children. 
As  we  improve  our  condition  mentally  or  bodily,  so 
will  our  posterity  be  gainers,  and  as  we  degrade  our 
natures,  so  shall  our  children  suffer  degradation.  Like 
begets  like,  and  whether  the  particular  bent  in  the 
parent  be  for  good  or  evil,  toward  health  or  disease  of 
*  "Physiology  and  Pathology  of  the  Mind,"  by  H.  Maudsley,  M.D. 


16  MARRIAGE  AND  DISEASE. 

mind  or  body,  it  will  to  a  certainty  leave  its  mark  upon 
the  offspring. 

The  fact  that  physical  characters  are  transmitted  no 
one  denies,  and  the  researches  of  Mr.  Galton  and  others 
prove  conclusively  that  quality  of  mind  is  as  frequently 
and  certainly  handed  down  from  parent  to  child  as  are 
physical  peculiarities.  When  do  we  read  the  biography 
of  a  man,  and  not  learn  from  what  ancestor  he  inherited 
this  particular  mental  or  moral  character,  and  from  what 
other  that?  As  the  scrofulous  beget  the  scrofulous, 
and  the  gouty  the  gouty,  so  do  the  neurotic  beget  the 
neurotic  and  the  insane  the  insane,  the  immoral  the 
immoral  and  the  criminal  the  criminal.  The  child 
whose  ancestors  have  been  criminals  and  jail -birds 
takes  as  naturally  to  crime  as  does  the  sheep-dog  to  his 
duties  on  the  hillside. 

As  man's  individuality — that  is,  his  own  peculiar 
conformation  of  mind  and  body — is  in  all  cases  the 
outcome  of  many  generations  of  building  up,  so  it 
must  be  in  all  cases  the  work  of  generations  to  eradi- 
cate any  well-marked  character,  or  otherwise  modify 
the  family  type.  Yet  in  every  case  the  type  can  be 
modified — for  evil  only  too  easily,  for  good  by  wise 
marriages  and  scientific  medical  treatment  persisted 
in.  Of  course  cases  are  to  be  found  on  every  hand 
where  reversion  to  the  healthy  is  impossible,  where  the 
individual  is  so  degenerate,  so  far  removed  from  the 
normal,  that,  despite  outward  appearances,  the  neces- 
sarily fatal  type  has  already  been  reached.  In  some 
of  these  cases,  as  in  the  impotent  and  sterile  idiot  and 


HEREDITY.  17 

cretin,  it  is  evident  to  the  world  that  Nature  has  put 
down  her  foot  and  refused  to  go  further ;  but  in  many 
others,  although  the  necessarily  fatal  type  has  been 
attained,  it  is  not  discoverable,  and  it  is  not  until, 
after  one  or  more  marriage,  we  find  them  childless,  or 
have  seen  their  wretched  children,  one  after  another, 
succumb  long  before  reaching  the  procreative  period, 
that  we  recognise  the  fact  that  the  end  has  been 
reached.  "When  men  wilfully  frustrate  the  noble 
purposes  of  their  being,  and  selfishly  ignore  the  laws 
of  hereditary  transmission,  Nature  takes  the  matter 
out  of  their  hands,  and  puts  a  stop  to  the  propagation 
of  degeneracy." 

I  will  give  a  case  in  point.  It  is  the  history  of  the 
family  of  a  patient  of  my  own,  and  shows  how,  when 
a  certain  low- water  mark  of  vitality  is  reached,  Nature 
rids  herself  of  the  useless : — 


' 


02 


-s 


-H 


" 


i! 


If 


i    -2-aS 
13    III 


HEREDITY.  19 

Now  the  degenerate  father  of  this  wretched  family 
most  likely  owed  his  arrival  at  maturity  to  artificial 
means.  In  natural  life  such  a  creature,  passionate, 
eccentric,  and  the  brother  of  a  suicide,  would  in  all 
probability  have  succumbed  to  his  innate  unfitness. 
We  do  not  know  whether,  or  how  often,  he  was  pre- 
vented by  others  from  carrying  out  "  Nature's  remedy," 
which  his  sister  in  a  fortunate  moment  applied,  but 
that  his  unstable  temper  and  eccentricity  would  have 
proved  fatal  at  an  early  age  in  natural  life  we  are  justi- 
fied in  assuming.  That  he  did  not  achieve  the  "  con- 
summation devoutly  to  be  wished  "  before  maturity,  or 
was  not  prevented  begetting  his  kind,  was  an  unmiti- 
gated misfortune  to  himself  and  to  the  world.  By 
his  life,  and  the  lives  of  his  unfortunate  children,  the 
world  gained  nothing.  By  his  early  death  or  enforced 
celibacy,  what  suffering  would  it  have  escaped !  But 
my  reason  for  bringing  forward  this  family  history 
at  present  was  to  demonstrate  how  infantile  mortality 
and  sterility  are  used  by  Nature  to  stamp  out  the  unfit. 
Of  this  miserable  man's  six  sons,  two  were  happily 
carried  off  in  infancy.  Each  of  the  other  four  lived  to 
beyond  sixty,  and  all  were  married.  They  had  amongst 
them  no  less  than  six  wives,  and  there  were  born  to 
them  twelve  children ;  yet  to-day  their  last  and  only 
representative  is  a  wretched,  crippled  melancholiac, 
whom  Nature  has  branded  with  sterility. 

Thus  do  all  hereditarily  transmitted  diseases,  or,  more 
correctly,  degenerations,  tend  to  one  goal — extinction 
of  the  family ;  and  it  is  only  by  judicious  marriages, 


20  MARRIAGE  AND  DISEASE. 

begun  before  the  degeneration  has  become  too  deep  and 
persisted  in  for  generations,  that  a  blighted  family  can 
rise  to  the  level  of  health  and  hope  to  live  in  posterity. 
In  the  family  cited  above  an  attempt  was  made  to 
continue  an  unfit  variety  of  the  human  race,  with  what 
result  we  have  seen,  viz.,  a  refusal  of  Nature  to  continue 
the  variety.  Of  course  it  is  only  where  the  natural 
laws  are  interfered  with,  as  they  are  in  civilised  life, 
that  such  could  have  occurred.  In  the  natural  state 
this  family,  in  all  likelihood,  would  have  been  stamped 
out  two  generations  earlier,  and  the  nineteen  descen- 
dants, whose  lives  were  but  a  cheerless  procession  to 
the  grave,  would  never  have  existed. 

In  natural  life  the  necessarily  fatal  type  is  reached 
much  earlier  than  under  civilisation,  and  consequently 
the  standard  of  health  is  distinctly  higher  among  bar- 
barous than  among  civilised  peoples.  Even  such  an 
apparently  innocent  abnormality  as,  say,  colour-blind- 
ness cannot  be  cultivated  in  the  natural  state,  for  the 
first  individual  bearing  the  degenerate  character  would 
undoubtedly  fall  a  victim  to  some  enemy  because  of  that 
character,  and  so  the  variety  would  be  lost.  Of  course, 
in  civilised  life  the  necessarily  fatal  type  is  ultimately 
attained  in  every  case  where  reversion  does  not  take 
place,  in  spite  of  all  man  can  do  to  stay  or  prevent  that 
consummation.  Thus  Nature  ultimately  rights  herself 
in  all  cases  by  setting  her  veto  upon  the  perpetuation 
of  disease,  and  were  it  not  for  the  suffering  experienced 
before  oblivion  is  reached,  nothing  need  be  said ;  the 
erring  might  be  left  to  their  fate.  But  this  suffering, 


HEREDITY.  21 

which  is  serious  even  in  natural  life,  becomes  grievous 
in  these  days  of  the  higher  civilisation,  when  those  who 
owe  their  continuance  in  life  to  the  exertions  of  others 
are  not  only  permitted,  but  are  aided  by  every  device 
known  to  science,  to  propagate  their  kind.  Now-a-days, 
when  the  maniac,  the  melancholiac,  and  the  would-be 
suicide  of  yesterday,  the  imbecile,  the  epileptic,  and  the 
habitual  drunkard  are  married  and  given  in  marriage, 
the  suffering  has  become  so  terrible,  the  contamination 
of  the  race  so  great,  and  the  care  of  the  useless  offspring 
begotten  so  heavy  a  charge  upon  the  community,  that 
if  some  effort  be  not  made  voluntarily  to  stay  this 
curse  upon  the  land,  the  Legislature  must  be  called 
upon  to  interfere. 

As  I  have  already  said,  excepting  only  the  idiot  and 
the  raving  maniac,  who  in  the  eye  of  the  law  are  un- 
able to  make  a  contract  binding  on  themselves,  there 
is  no  one  so  diseased,  crippled,  or  deformed  that  he  or 
she  may  not  marry  and  become  the  parent  of  a  suffering, 
helpless  family,  so  far  as  the  law  is  concerned.  That 
this  should  be  so  is  a  scandal  upon  our  boasted  civilisa- 
tion. Why  should  the  industrious  citizen,  who  for  years 
worked  hard  and  saved  money  that  he  might  marry 
with  some  reasonable  prospect  of  being  able  to  support 
his  family  when  it  came,  be  called  upon  to  support 
the  helpless,  worthless  offspring  of  the  drunkard,  the 
imbecile,  the  criminal,  and  every  other  wastrel  who 
chooses  to  become  a  parent  ?  But  this  great  question 
hardly  comes  within  the  purview  of  this  work,  and, 
notwithstanding  its  fascination,  we  must  leave  it  for 


22  MARRIAGE  AND  DISEASE. 

the  present.  Speaking,  however,  from  a  purely  scientific 
standpoint,  I  will  assert,  without  fear  of  contradiction 
from  those  able  to  judge,  that  legislation  tending  to 
limit  the  propagation  of  the  insane,  the  epileptic,  the 
drunken,  the  criminal,  and  the  pauper  would  have  a 
markedly  beneficial  effect  upon  the  health  and  comfort 
of  our  people.  As  Dr.  Benjamin  Ward  Eichardson  has 
wisely  said,  "  The  first  step  towards  the  reduction  of 
disease  is,  beginning  at  the  beginning,  to  provide  for 
the  health  of  the  unborn.  The  error  commonly  enter- 
tained, that  marriageable  men  and  women  have  nothing 
to  consider  except  wealth,  station,  or  social  relation- 
ships, demands  correction.  The  offspring  of  marriage, 
the  most  precious  of  all  fortunes,  deserves,  surely,  as 
much  forethought  as  is  bestowed  on  the  offspring  of 
the  lower  animals.  If  the  intermarriage  of  disease 
were  considered  in  the  same  light  as  the  intermarriage 
of  poverty,  the  hereditary  transmission  of  disease,  the 
basis  of  so  much  misery  in  the  world,  would  be  at  an 
end  in  three,  or  at  most  four  generations."  * 

Yet,  notwithstanding  all  that  has  been  said  of  the 
relentlessness  of  this  law  of  heredity,  the  unfortunate 
inheritor  of  a  poorly  or  viciously  developed  mind  or 
body  is  not  to  fold  his  hands  and  say,  "  It  is  useless 
for  me  to  strive."  Not  a  single  passage  in  this  book 
is  intended  to  support  such  a  view.  Let  such  unfor- 
tunate work,  and  work  patiently  in  a  good  cause. 
Although  he  might  as  well  hope  to  rid  himself  of  his 
shadow  as  of  any  deeply  marked  hereditary  tendency, 
*  "  Diseases  of  Modern  Life." 


HEREDITY.  23 

whatever  its  most  prominent  traits  may  be,  he  may 
by  strenuous  effort,  by  judicious  treatment,  and  a  pure 
and  healthy  life,  do  much  to  bring  himself  nearer  to 
that  grand  ideal  of  manhood  which  none  of  us  approach 
too  closely.  Nor  can  any  man  be  engaged  in  a  nobler 
or  holier  work  than  purging  the  body  of  the  sins  of  its 
fathers. 

This,  then,  is  heredity.  This  mysterious,  unknown, 
and  possibly  unknowable  something  which  moulds  the 
child  after  the  fashion  of  its  parents.  It  is  this  law 
which  has  made  man  what  he  now  is ;  it  is  this  law 
which  shall  make  man  what  he  may  yet  ba 


CHAPTER  II. 

VARIATIONS. 

So  far  we  have  been  speaking  of  heredity  broadly,  as 
it  affects  the  race  generally,  and  as  if  there  were  no 
other  influence  at  work  in  moulding  the  offspring  than 
this  "  like  father  like  son  "  rule.  Certainly  there  is 
no  other  influence  which  exercises  a  tithe  of  the  power 
which  heredity  pure  and  simple  does  in  foreordaining 
what  the  child  shall  be ;  but  if  we  consider  for  a 
moment,  we  shall  see  that  there  must  be  other  influences 
at  work.  If  it  were  not  so,  if  heredity  were  not  in  any 
way  interfered  with,  the  child  must,  of  necessity,  be  a 
perfect  mean  of  the  parents,  and  all  children  of  the 
same  parents  must  be  identical.  Now  we  know  that 
this  is  not  so.  An  exact  likeness,  physical,  mental,  or 
moral,  is  never  transmitted  by  inheritance ;  such  a 
thing  is  impossible.  It  has  been  said  that  no  two 
blades  of  grass  are  exactly  alike,  and  it  is  certain 
that  no  two  faces,  bodies,  minds,  or  moral  natures  are 
exactly  alike.  Each  person  is  endowed  with  a  certain 
individuality  which  distinguishes  him  from  all  others. 
At  times  we  do  meet  with  a  case  in  which  the  child  is, 
to  a  marvellous  degree,  a  reproduction  of  one  or  other 


VARIATIONS.  25 

parent,  in  feature,  form,  and  limb,  or  perhaps  in  mind,  or 
even  in  both ;  but  such  cases  are  extremely  rare,  and  in 
no  case  must  we  ever  hope  to  find  a  perfect  likeness. 
Nature  does  not  slavishly  follow  any  one  type  or  pattern, 
but  revels  in  infinite  variety  within  certain  limits. 

The  slight  variations  constantly  met  with  in  the 
family  are  due,  for  the  most  part,  to  the  various  blend- 
ings  of  the  parental  characters,  which  a  moment's  con- 
sideration will  show  may  be  endless.  Eemnants  of 
the  countless  characters  of  the  ancestors  are  present 
in  each  parent,  some  strong,  some  weak,  some  standing 
out  prominently,  others  almost  effaced.  Nor  are  they 
even  thus  a  constant  quantity,  for  while  the  life  of 
the  individual  develops  one,  it  may  allow  another  to 
fade  almost  to  oblivion.  Thus  the  children  begotten 
at  different  periods  of  life,  even  if  they  were  mere 
examples  of  the  mean  of  the  parents,  must  vary 
considerably.  As  it  is,  one  child  will  inherit  some 
peculiar  character  from  one  parent,  in  whom  that  par- 
ticular character  is  just  then  prominent  and  active; 
another  child  will  inherit  largely  some  other  character 
from  the  same  or  the  other  parent,  while  a  third  child 
may,  by  some  happy  blending  of  perhaps  mediocre 
parental  characters,  become  the  fortunate  inheritor  of 
some  physical  or  mental  character  of  a  high  order ;  or, 
conversely,  by  some  unlucky  mischance,  parental  char- 
acters, good  in  themselves,  may  combine  to  form  a 
compound  markedly  bad. 

^"The  inheritance  of  the  child  is  a  piece  of  patchwork, 
a  thing  of  shreds  and  patches.     It  is  a  mosaic  made 


26  MARRIAGE  AND  DISEASE. 

up  of  innumerable  characters,  all  varying  in  form  and 
tint,  and  changing  with  every  generation  as  some  drop 
out  and  new  ones  take  their  place.  The  variously 
coloured  pieces  are  so  numerous  that  even  Nature  cannot 
arrange  them  twice  in  exactly  the  same  order.  But 
although  they  are  differently  arranged  in  every  case, 
each  family  has  what  might  be  called  a  "family 
pattern."  In  every  member  of  the  family  the  tracery 
and  tinting  may  differ  in  parts,  yet  there  is  a  common 
resemblance  which  is  seldom  wanting.  This  "family 
pattern  "  is  being  constantly  modified  by  the  introduc- 
tion of  fresh  characters,  which  in  the  course  of  time 
may  change  the  pattern  altogether;  but  such  change 
is  always  very  gradual.  In  the  ordinary  course  there 
is  no  rude  interference  with  the  general  arrangement, 
which  maps  out  the  great  fundamental  curves  and 
grouping  which  give  a  common  likeness,  and  make 
children  of  the  same  family  like,  however  unlike. 
Occasionally  such  radical  changes  do  occur,  and  the 
graceful  curves  of  health  may  be  distorted  to  the 
angles  of  disease.  The  beautiful  tintings  which  repre- 
sent mental  and  moral  worth  may  be  replaced  by 
glaring,  ill-placed  patches  of  colour,  or  all  order  may 
be  lost  in  the  chaos  of  idiocy ;  or,  again,  the  pattern 
may  take  on  the  beauty  of  genius.  But  no  such 
arrangements  continue  long.  They  never  become  fixed 
family  characters.  In  one  or  two  generations  the  old 
family  pattern — modified,  it  may  be,  but  still  the  old 
pattern — will  appear  again,  or  the  pavement  will  take 
on  the  blankness  of  death. 


VARIATIONS.  27 

This  blending  of  the  parental  characters,  which  we 
see  is  capable  of  endless  variety,  is  often  very  con- 
siderably fettered  by  the  fact  that  all  characters  are 
not  equally  potent ;  generally  speaking,  those  more 
recently  acquired  are  not  transmitted  with  the  same 
certainty  that  those  of  long  standing  are.  These  latter 
are  said  to  have  gained  a  "prepotency"  by  long 
descent;  by  repeated  transmission  they  have  become 
fixed  and  prominent  characters  in  the  family,  and  the 
presence  of  one  such  character  in  a  parent  tends  to 
materially  limit  variety  in  the  offspring.  But  we  shall 
consider  this  subject  later  on,  when  we  have  learnt 
something  of  how  "acquired  characters"  affect  the 
family. 

Again,  it  should  be  pointed  out  that  what  are  com- 
monly looked  upon  as  most  striking  variations  in  the 
family,  are  often,  in  reality,  not  variations  at  all,  but 
reversions.  In  such  cases  the  branch  of  the  family  to 
which  the  parent  belongs  has,  in  consequence  of  some 
combination  of  circumstances,  deviated  from,  the  family 
type.  With  each  generation  the  divergence  has  in- 
creased, but  it  has  not  gained  any  fixity,  and  with  the 
infusion  of  fresh  blood  the  offspring  "  throws  back  " 
to  the  original  family  type.  It  is  looked  upon  as  a 
variation,  whereas  it  is  a  fair  representative  of  the 
family,  and  it  is  the  parent  who  is  at  fault.  But  this 
subject  of  reversion  we  shall  also  postpone  for  a  short 
time,  while  we  endeavour  to  see  what  effect  is  exerted 
upon  the  race  by  the  environment — that  is,  the  action 
of  the  whole  outer  world. 


28  MARRIAGE  AND  DISEASE. 

It  would  perhaps  be  convenient  to  point  out  here 
that  all  variations  from  the  normal  standard  of  deve- 
lopment and  health  can  be  classed  under  two  heads, 
physiological  and  pathological : 

Physiological  where  the  variation  takes  the  form  of 
special  development  in  any  healthy  direction,  whether 
physical,  mental,  or  moral ;  and 

Pathological  where  the  variation  tends  downwards  to 
degeneration  and  disease,  or  to  absence  of  due  develop- 
ment, as  where  insanity,  idiocy,  bodily  deformity,  gout, 
scrofula,  and  like  hereditary  diseases  and  imperfections 
brand  the  family  stock — that  is,  where  the  variation 
tends  toward  dissolution. 

And  now  let  us  briefly  consider  the  action  of  the 
environment  in  the  production  of  variations.  The 
influence  of  the  environment  is  at  work  from  the 
instant  of  conception.  The  child's  environment,  made 
up  of  pressure,  food,  air,  exercise,  education,  associa- 
tion— the  whole  outer  world,  in  fact,  is  with  all  Nature 
ever  changing;  and  as  it  is  impossible  that  this  ever 
can  be  identical  in  any  two  cases,  so  it  is  impossible, 
on  this  ground  alone,  that  any  two  children  ever  can 
be  exactly  alike.  Thus  each  individual  must  be  a 
variation  from  the  mean  of  his  parents,  as  he  must 
also,  and  from  the  same  cause,  be  a  variation  from 
the  normal.  (The  normal  is  of  necessity  ideal,  as  we 
cannot  point  to  any  individual  and  say,  "This  is  the 
normal  standard,"  for  the  reason  that  no  one  is, 
perhaps,  absolutely  healthy,  and  every  one  has  been, 
and  is  being,  modified  by  his  environment.)  But 


VARIATIONS.  29 

although  all  persons  are  thus  variations  from  the 
normal  stock  because  of  the  action  of  the  environment, 
it  is  not  necessary  to  look  upon  them  as  such.  For 
all  practical  purposes  the  average  of  the  healthy  mass 
may  be  taken  as  the  normal  standard.  Practically 
these  finer  variations  are  of  no  moment,  and  having 
recognised  their  existence  and  cause,  we  may  pass  on 
to  the  consideration  of  the  more  gross.  It  is  only  in 
those  cases  in  which  the  individual  has  strayed  so  far 
from  the  normal  as  to  be  "  out  of  the  common  "  that 
we  are  asked  to  look  upon  him  as  a  variation,  and 
consider  whether  he  is  to  be  classed  as  physiological 
or  pathological — whether  he  is  on  the  way  to  a  higher 
development,  or  on  the  down  path  to  extinction. 

This  action  of  the  environment  upon  the  individual 
has  not  been  given  the  attention  it  deserves  in  this 
connection.  Some  writers  refuse  to  recognise  it  as 
a  cause  of  variation,  believing  that  its  action  affects 
the  individual  only  slightly,  and  does  not  modify  the 
family  type  through  him ;  but  we  shall  find,  upon 
inquiry,  that  it  is  one  of  the  most  potent  influences  at 
work  in  the  changing  of  family  and  racial  types. 

Man,  as  we  know  him,  is  a  creature  of  circum- 
stances ;  he  is  moulded  by  his  surroundings.  His  con- 
dition of  mind  and  body,  in  whatever  position  we  find 
him,  is  the  result  of  the  action  of  the  environment 
upon  him,  and  as  his  surroundings  are  ever  changing,  so 
is  he  ever  changing  with  them.  No  man  is  mentally, 
morally,  or  physically  exactly  what  he  was  even  a 
year  ago,  and  no  one  will  aver  that  this  change  is  not 


30  MARRIAGE  AND  DISEASE. 

in  great  part  the  result  of  contact  with  the  outer 
world.  No  man  can  cut  himself  off  from  the  mould- 
ing influence  of  surrounding  Nature,  of  which  he  is  a 
part,  and  the  impressions  received  from  it  will  affect 
not  only  him  but  his  posterity.  When  Jacob  modified 
the  environment  of  his  flocks  by  fencing  them  around 
with  white  rods,  he  did  not  do  so  for  the  purpose  of 
affecting  the  flocks  alone,  but  that  he  might  profit  by 
its  modifying  influence  upon  the  generations  to  follow. 
But  this  is  a  subject  for  demonstration.  Let  us  take 
a  case  and  see  how  this  influence  works.  Suppose 
we  take  twin  brothers,  who,  notwithstanding  the  in- 
equality of  environment  they  have  experienced  in 
pre-natal  life  (as  difference  in  position  and  pressure, 
size  and  arrangement  of  placentae,  &c.),  have  entered 
the  world  as  like  to  each  other  as  may  be.  Now, 
send  one  of  these  infants  to  a  healthy  farmhouse  to  be 
brought  up  a  ploughboy,  and  let  the  other  be  reared 
in  the  back  slums  of  a  great  city  in  the  midst  of 
poverty  and  vice,  and  what  will  be  the  result  ?  It 
will  be  this :  that  the  one  who  breathes  the  pure  air 
of  heaven,  feeds  on  a  plain  but  healthy  fare,  and  does 
an  honest  day's  work  \vith  his  muscles  every  day,  will 
at  least  develop  the  physical  part  of  his  nature,  and 
reach  manhood  full  of  health  and  strength,  and  ex- 
perience a  delight  in  living ;  while  his  brother,  bred 
in  the  lanes  of  a  great  city,  seldom,  if  ever,  breathing 
other  than  a  vitiated  atmosphere,  and  subsisting  on 
food  wanting  in  many  of  the  essential  constituents  of 
a  healthy  diet,  will  arrive  at  manhood — should  he 


VARIATIONS.  31 

reach  that  stage — wan  and  pinched,  no  more  like  his 
twin  brother  in  the  country  than  Hamlet  was  to 
Hercules.  This  is  the  action  of  the  environment 
upon  the  individual.  Here  we  see  its  effect  upon 
the  physical  organisation  during  the  early  years  of 
life,  and  no  proof  is  needed  that  its  effect  upon  the 
mental  and  moral  natures  is  equally,  if  not  still  more 
powerful 

But  let  us  follow  these  brothers.  Suppose  the 
ploughman,  full  of  life  and  vigour,  marries  a  strong, 
healthy  country-woman,  while  his  town-bred  brother 
marries  her  sister,  who,  like  himself,  has  been  brought 
up  in  poverty  in  a  large  town,  and  whose  store  of  health 
is  more  or  less  reduced  in  consequence ;  can  we  for  a 
moment  suppose  that  the  natural  inheritance  of  the 
children  of  these  twin  brothers  and  these  sisters  will 
be  identical  ?  The  one  family,  having  inherited  the 
sound  physical  constitution  of  the  ploughman  and  his 
healthy  wife,  will  grow  up  vastly  different  from  their 
stunted,  pale-faced,  town-bred  cousins,  who  show  the 
second  step  on  the  downward  path  leading  to  the 
extinction  of  the  family :  different  as  is  the  typical 
yeoman  from  the  typical  Cockney,  who,  it  has  been 
said,  "  has  no  grandfather."  * 

This  is   the  action  of  the   environment  upon   the 

*  Mr.  Cantlie,  aftsr  prolonged  and  careful  search,  could  not  find 
a  single  person  whose  ancestors,  from  the  grandparents  downwards, 
had  been  born  and  bred  in  London.  He  describes  some  miser- 
able creatures  who  most  nearly  approached  this  record,  and  then 
remarks  : — "  I  have  never  come  across  the  children  of  any  such, 
and  I  believe  it  is  not  likely  I  ever  sl^all.  Nature  steps  in  and 
denies  the  continuance  of  such."— "Degeneration  amongst  Londoners" 


32  MARRIAGE  AND  DISEASE. 

physical  organisation,  and  as  it  acts  there,  so  does  it 
in  the  mental  and  moral  worlds.  As  the  muscular 
system  and  health  can  only  be  developed  and  pre- 
served by  good  food,  air,  and  exercise,  so  the  mental 
faculties  can  only  be  enlarged  and  brightened  by 
education  and  example;  and  as  surely  as  the  blush 
of  health  fades  before  starvation  and  disease,  so  does 
moral  loveliness  fade  in  the  presence  of  vice  and 
degradation.  "Train  up  a  child  in  the  way  he  should 
go,  and  when  he  is  old  he  will  not  depart  from  it," 
is  as  true  of  tne  physical  and  mental  as  it  is  of  the 
moral  nature. 

These,  then,  are   the  causes  of  variations  in  the 
family,  viz. : — 

1.  The  various  and  unequal  blending  of  the  parental 
characters,  which  possibly,  and  in  some  cases  certainly, 
depends  upon  the  humour,  or  mental  or  bodily  con^ 
dition,  of  the  parents  when  they  become  such. 

2.  Reversion,  or  "  throwing  back "  to  a  family  type 
lost  some  generations  before ;  and 

3.  The  action  of  the  environment  upon  the  child 
from  the  moment  of  its  conception. 


CHAPTER  III. 

ACQUIRED   CHARACTERS. 

"  Man  is  subject  to  all  the  general  laws  of  animal  nature.  The 
law  of  heredity  is  one  of  those  from  which  he. cannot  escape,  and 
it  is  this  law,  which,  under  the  influence  of  the  conditions  of  life, 
fashions  races  and  makes  them  what  they  are."— DE  QUATRE- 

PAGES. 

FROM  the  little  we  have  heard  of  the  action  of  the 
environment  upon  the  individual,  it  will  be  under- 
stood that  it  is  not  alone  the  blend  of  family  char- 
acters, received  from  our  parents,  which  we  in  our 
turn  hand  down  to  our  children,  but  those  characters 
modified,  as  they  may  be  for  better  or  worse,  for  good 
or  evil,  in  our  own  lives,  together  with  those  acquired 
by  habit,  occupation,  mode  of  life — by  the  action  of 
the  environment,  in  fact.  We  should  never  forget 
that  we  live  not  for  ourselves  alone,  but  for  posterity : 
that  we  hold  the  well-being  of  the  race  in  trust  for 
our  children,  and  should,  as  honest  trustees,  let  the 
estate  pass  on  to  the  next  heirs,  free  from  waste  or 
dilapidation  when  our  life-interest  in  it  is  done.  The 
man  (or  woman)  who  undermines  his  physical  health, 
or  degrades  his  mental  or  moral  nature,  is  dishonest. 
He  is  robbing  the  children  yet  unborn.  The  spend- 


34  MARRIAGE  AND  DISEASE. 

thrift,  who  encumbers  the  broad  acres  of  the  family 
estate,  and  leaves  his  children  penniless,  no  more  surely 
robs  his  children  of  their  rightful  heritage,  than  does 
the  man  (or  woman)  who,  by  a  wicked  and  vicious 
life,  degrades  his  nature,  thereby  making  his  children 
physical,  mental,  or  moral  beggars. 

Some  students  of  heredity  deny  that  characters 
acquired  by  the  individual  are  transmitted  to  the 
offspring,  and  foremost  amongst  these  is  the  German 
savant  Weismann,  who  has  done  so  much  to  advance 
our  knowledge  on  all  things  relating  to  heredity.  With 
these,  however,  we  cannot  agree.  We  hold,  with  the 
great  majority  of  authorities  on  the  subject,  that  all 
characters  acquired  by  the  individual  have  a  distinct 
effect,  more  or  less  powerful,  upon  the  offspring  of  the 
individual  To  admit  that  these  acquired  characters 
are  not  transmitted,  nor  transmissible,  is  to  make  a 
clean  sweep  of  evolution.  If  acquired  characters  have 
no  influence  upon  the  offspring,  from  whence  came  the 
innumerable  characters  which  are  to-day  transmitted  ? 
Are  they  each  the  result  of  a  distinct  creative  act, 
and,  if  not,  how  did  they  arise,  how  did  they  come 
into  existence?  Have  they,  and  every  other  of  the 
countless  myriads  of  characters  which  are,  and  which 
through  all  past  ages  have  been,  exhibited  in  all  the 
various  human  races,  been  originally  and  ever  present  in 
the  germ  plasm  ?  Some  physiologists  assert  that  this  is 
so,  that  the  germ  cell  acts  but  as  a  torch  whose  touch 
lights  up  the  spark  of  life,  and  which  is  passed  on  from 
generation  to  generation,  unchanged  and  unchange- 


ACQUIRED  CHARACTERS.  35 

able ;  but  this  theory  is  hardly  less  difficult  of  belief 
than  the  old  theory  of  the  germ  cell  containing  the 
animal  to  be  produced  in  miniature.  These  physio- 
logists hold  that  the  cells  possessing  these  wonderful 
powers  of  production,  having  started  the  condition  we 
know  as  life  in  the  new  being,  separate  themselves 
from  the  organising  mass  of  the  foetus  at  an  early 
period,  take  no  part  in  its  development,  but  simply 
lie  apart,  dormant  and  unimpressionable  within  it, 
until  the  new  creature  reaches  the  procreative  period, 
when  they  wake  up  and  are  ready  to  be  passed  on  to 
the  next  generation,  there  to  light  up  life,  and  having 
lost  nothing  in  the  operation  and  gained  nothing, 
again  lie  dormant  until  the  maturity  of  that  genera- 
tion calls  them  forth  once  more. 

This  is  an  ingenious  and  a  pretty  theory,  but  it  is, 
as  I  have  said,  difficult  of  belief.  In  the  first  place, 
these  germ  cells  must,  like  all  other  living  protoplasm, 
be  nourished.  This  nourishment  is  received  from  the 
organism  in  which  they  lie.  We  know  .that  every- 
where in  nature  the  creature  is  influenced  by  its 
environment.  Why  should  these  cells  be  the  only 
exception?  Again,  it  is  clear  that  these  cells  which 
bear  such  extraordinary  potentiality  must  proliferate 
to  a  marvellous  extent,  for  while  the  amount  of 
protoplasm  set  aside  for  this  purpose  on  the  formation 
of  a  new  creature  is  a  microscopic  quantity,  on  that 
creature  attaining  the  procreative  stage  equally  potent 
germ  cells  are  thrown  off  with  lavish  prodigality,  and 
this  is  continued  through  the  whole  period  of  pro- 


36  MARRIAGE  AND  DISEASE. 

creative  life.  In  the  human  female  the  ovaries  have 
been  estimated  to  contain  about  72,000  ova,  while  in 
the  male  the  vital  units  produced  are  simply  innumer- 
able. Therefore  this  magic  germ  must  transmit  its 
powers  to  thousands  of  other  cells.  These  other  cells 
are  portions  of  the  general  organism  of  the  parent, 
and  that  these  should  bear  some  impress  indicative 
of  their  origin  and  former  life  is  not  too  strained  an 
inference.  These  masses  of  protoplasm  are  part  and 
parcel  of  the  adult  animal  organism,  we  know  that 
they  are  affected  as  other  cells  by  certain  diseases 
contracted  by  the  organism,  and  it  is  not  too  much 
to  suppose  that,  bathed  in  the  same  fluids  and  fed 
from  the  same  blood-stream,  they,  like  every  other 
cell  in  the  economy,  should  be  liable  to  the  action  of 
the  environment ;  and  that  this  changed  conditio'n, 
whatever  it  may  be,  should  re- appear  in  the  new 
creatures  or  organisms  of  which  they  are  the  first 
cause  and  foundation,  it  is  but  reasonable  to  expect. 
As  Sir  William  Turner  said  in  his  address  before  the 
British  Association  at  Newcastle  in  1889,  "Those  who 
uphold  the  view  that  characters  acquired  by  the  soma 
[  =  individual]  cannot  be  transmitted  from  parent  to 
offspring  undoubtedly  draw  so  large  a  cheque  on  the 
bank  of  hypothesis,  that  one  finds  it  difficult,  if  not 
impossible,  to  honour  it." 

In  support  of  this  theory  of  the  non-transmissibility 
of  acquired  characters,  it  is  generally  pointed  out  that 
there  is  little  or  no  proof  of  mutilations  in  the  parent, 
such  as  the  loss  of  an  eye  or  a  limb,  being  reproduced 


ACQUIRED  CHARACTERS.  37 

in  the  offspring.  This  is  to  a  certain  extent  true.  We 
do  not  find  that  the  man  who  has  lost  his  right  hand 
begets  children  with  imperfect  hands,  nor  do  we 
expect  to  find  it.  If  the  injury  or  mutilation  be  to 
some  exquisitely  sensitive  organ,  as  the  brain,  we  may 
have  it  repeated  in  the  offspring,  as  we  do  at  times 
find  epilepsy  acquired  by  the  parent  reproduced  in 
the  children ;  but  in  the  great  majority  of  such  injuries 
the  step  is  too  great  a  one  for  Nature,  who  does  nothing 
by  leaps  and  bounds.  From  the  perfect  hand,  the  work 
of  ten  thousand  generations,  to  the  imperfect  hand 
bearing  two  or  three  fingers  is  too  radical  a  change ; 
but  let  the  change  be  sufficiently  gradual,  and  assuredly 
we  shall  have  the  transmitted  type  changed.  See 
what  changes  can  be  brought  about  in  this  same 
member,  the  hand,  within  a  few  generations.  Look  at 
the  narrow,  elegant,  small-boned  hand  of  which  the 
aristocratic  family,  whose  members  have  not  been 
engaged  in  manual  labour  for  generations,  is  so  proud : 
compare  it  with  the  broad-palmed,  large- boned,  knotty- 
fingered  hand  of  the  navvy,  the  "  horny-handed  son  of 
toil,"  and  tell  us  whether  these  hands  were  born  alike. 
And  just  as  the  hand  can  be  modified,  so  can  any  other 
limb  or  organ,  so  can  the  mind,  so  can  the  moral 
nature. 

I  might  give  many  examples  of  the  transmission 
of  acquired  physical  characters,  but  I  shall  only  men- 
tion two  which  are  in  themselves  most  interesting. 
The  first  is  the  process  of  degeneration  which  is  going 
on  among  civilised  peoples  in  the  little  toe.  Herr 


38  MARRIAGE  AND  DISEASE. 

Pfitzner  has  made  a  great  number  of  observations 
as  to  the  condition  of  this  member,  and  has  found 
that  in  31  per  cent,  of  males  and  41.5  per  cent,  of 
females  the  two  terminal  bones  are  fused  into  one, 
which  is  very  little,  if  at  all,  larger  than  the  ter- 
minal bone  should  be.  Nor  was  this  phenomenon 
confined  to  adults;  he  found  it  equally  common  in 
children,  and  even  in  infants.  Whether  the  process 
will  continue  until  the  fifth  toe  disappears  we  cannot 
say,  but,  knowing  what  we  do  of  evolution,  there  is 
every  reason  to  think  so.  The  second  case  which  I 
shall  mention,  is  the  gradual  disappearance  of  the 
wisdom-tooth  in  civilised  man.  It  is  clear  that  civi- 
lised man  does  not  require  the  strength  of  jaw  and 
amount  of  grinding  surface  he  did  before  he  discovered 
how  much  jaw- labour  could  be  done  by  knives  and 
forks  and  cookery,  and  as  evolutionists  we  would 
expect  to  find  in  him  jaws  and  teeth  less  powerfully 
developed  than  in  his  still  savage  brother.  And  that 
is  exactly  what  we  do  find.  In  all  savage  races  we 
find  the  whole  masticatory  apparatus,  bones,  teeth, 
and  muscles,  much  better,  that  is,  more  strongly 
developed  than  in  the  civilised  races.  More  than  this, 
we  find  that  as  the  jaws  develop  less  fully  the  last 
tooth,  the  wisdom-tooth,  is  dying  out.  Mantegazza 
in  a  long  series  of  observations  found  the  wisdom-teeth 
absent  in  19  per  cent,  of  members  of  the  lower  races, 
while  they  are  absent  in  42  per  cent,  of  civilised  man- 
kind. Now  both  these  conditions  are  acquired,  the 
absence  of  the  teeth  and  the  atrophy  of  the  toe,  and 


ACQUIRED  CHARACTERS.  39 

how  they  are  to  be  accounted  for  otherwise  than  by 
hereditary  transmission  I  am  at  a  loss  to  understand. 

Under  changed  conditions  a  plant,  an  animal,  or  a 
man  will  change.  There  must  be  harmony.  Nature 
will  not  long  tolerate  a  discord.  The  creature  must 
maintain  the  equilibrium  between  himself  and  his 
surroundings  somehow,  or  cease  to  exist,  and  he  can 
only  do  this  in  one  of  two  ways,  either  he  must  suit 
himself  to  his  surroundings,  or  so  modify  his  surround- 
ings that  they  may  suit  him.  This  latter  man  fre- 
quently attempts,  but  he  can  at  best  only  partially 
carry  it  out,  and  so  to  regain  the  equilibrium  he  must 
himself  change.  Examples  of  this  abound.  It  is  seen 
when  a  people  are  transferred  from  one  climate  or 
part  of  the  globe  to  another.  In  such  cases  changes 
are  very  soon  brought  about  in  the  people,  and  they 
develop  characters  which  were  not  present  before  their 
translation.  At  first  these  recently  acquired  characters 
are  not  at  all  firmly  fixed,  and  there  is  great  liability 
in  the  offspring  to  reversion  toward  the  original  family 
type,  but  with  each  generation  the  new  characters  be- 
come more  deeply  marked,  more  intimately  ingrained 
in  the  organism,  and  the  liability  to  reversion  being 
gradually  lessened,  the  new  characters  become  fixed 
and  constant  in  the  family.  We  have  a  good  example 
of  this  in  the  Yankee,  for,  as  Sir  William  Turner 
says,  "Most  of  us  can  distinguish  the  nationality  of 
a  citizen  of  the  United  States  by  his  personal  appear- 
ance, without  being  under  the  necessity  of  waiting  to 
hear  his  speech  and  intonation." 


40  MARRIAGE  AND  DISEASE. 

Again,  no  one  will  deny  that  the  appetite  of  the 
drunkard  is  an  acquired  character,  and  cannot  he 
transmit  his  accursed  appetite  to  his  children  ?  Cannot 
he  drink  himself  into  epilepsy  or  insanity,  and  after- 
wards beget  children  who  shall  inherit  his  shattered 
nervous  system,  just  as  the  young  of  the  guinea-pigs 
in  which  Brown-Sequard  had  artificially  induced 
epilepsy  inherited  that  diseased  condition  ?  Cannot 
the  compositor  or  the  dressmaker,  by  over-work  in 
ill-ventilated  rooms,  by  want  of  pure  air  and  healthy 
food,  develop  a  predisposition  to  phthisis ;  and  shall 
we  expect  the  children  of  such  to  escape  scot-free  and 
inherit  nothing  of  their  parents'  acquired  degenerate 
condition  ? 

If  acquired  characters  cannot  be  transmitted,  as 
some  say  they  cannot,  how  are  we  to  explain  the 
degeneracy  and  early  extinction  of  the  poor  families 
of  our  great  cities,  where,  in  three  or  four  generations, 
poverty,  starvation,  and  dirt  modify  the  family  to 
extinction  ?  On  this  subject  Dr.  Maudsley  says : — 
"  Over-population  leads  to  deterioration  of  the  health 
of  the  community  by  overcrowding  and  the  insanitary 
condition  of  dwelling-houses  which  it  occasions  in 
towns.  Not  fevers  only,  but  scrofula,  perhaps  phthisis, 
and  certainly  general  deterioration  of  nutrition  are 
thus  generated  and  transmitted  as  evil  heritages  to 
future  generations ;  the  acquired  ill  of  the  parent 
Incomes  tlie  inborn  infirmity  of  the  offspring."  As  we 
have  already  heard,  Mr.  Cantlie  failed  after  prolonged 
and  careful  search  to  find  a  single  person  of  the  poorer 


ACQUIRED  CHARACTERS.  41 

classes  whose  ancestors,  from  the  grandparents  down, 
had  been  born  and  bred  in  London.  How  was  this  ? 
Can  it  be  explained  otherwise  than  by  the  gradual 
extinction  of  the  family  by  transmitted  physical  in- 
feriority or  impaired  vitality  ?  The  healthy  labourer 
going  into  London  loses  a  part  of  his  vitality  because 
of  the  wretched  conditions  under  which  he  exists,  and 
in  a  few  years  he  is  a  much  inferior  man  to  what  he 
once  was.  His  children  inherit  his  impaired  constitu- 
tion, and  in  their  turn  deteriorate  a  stage  further,  beget 
a  still  more  wretched  offspring,  and  so  on  to  extinction. 
Mr.  Cantlie,  after  describing  some  miserable  specimens 
of  humanity  he  discovered  who  nearly  approached 
what  he  was  in  search  of,  says  : — "  I  have  never  come 
across  the  children  of  any  such,  and  I  believe  it  is  not 
likely  I  ever  shall.  Nature  steps  in  and  denies  the 
continuance  of  such." 

Thus  does  the  environment  create,  modify,  and  ex- 
tinguish physical  characters,  and  its  action  is  not  less 
effectual  in  the  mental  and  moral  worlds.  Just  as  the 
degenerate  physical  development  of  the  poor  dwellers 
in  large  cities  is  handed  down  from  parent  to  child,  so 
has  the  liability  to  scrofula,  gout,  rheumatism,  epilepsy, 
insanity,  and  drunkenness  been  acquired  and  trans- 
mitted, as  is  also  the  predisposition  to  crime  handed 
down  an  heirloom  in  that  degenerate  race  the  instinc- 
tive criminal.  Just  as  the  fine  physical  development 
of  the  yeoman  and  the  degenerate  frame  of  the  Cockney 
have  been  the  outcome  of  certain  conditions  of  environ- 
ment, so  have  the  clear  financial  insight  of  the  Hebrew, 


42  MARRIAGE  AND  DISEASE. 

and  the  mental  instability  of  the  neurotic  family  been 
developed  by  ages  of  habit.  "Habit  becomes  second 
nature"  is  an  old  saying  which  sums  up  what  we  have 
been  preaching,  viz.,  that  habit — or,  as  Shakespeare 
has  it,  use — long  continued  is  what  builds  up  our 
nature.  Hamlet  says  : — 

"Refrain  to-night, 

And  that  shall  lend  a  kind  of  easiness 
To  the  next  abstinence  :  the  next  more  easy : 
For  use  almost  can  change  the  stamp  of  nature." 

(  Darwin  says : — "  Characters  of  all  kinds,  whether 
j  old  or  new,  tend  to  be  inherited,"  and  of  the  truth  of 
the  statement  there  is  proof  everywhere  around.  The 
transmission  of  acquired  characters  is  well  exemplified 
in  some  of  the  inferior  animals,  as  for  example,  the  dog. 
No  one  will  assert  that  the  sheep-dog,  the  retriever, 
or  the  pointer  is  the  result  of  an  independent  creative 
act.  We  know  that  they  are  sprung  from  a  common 
stock,  although  they  are  now  so  widely  separated 
physically  and  mentally.  Each  one  by  a  certain  mode 
of  life  has  become  modified  from  the  original  type. 
The  well-bred  pointer,  that  is,  one  whose  ancestors  have 
been  trained  to  the  same  particular  duties  for  many 
generations  back — will  '  point/  as  we  say,  by  instinct, 
the  young  retriever  retrieve  to  hand  after  a  single 
lesson,  and  the  sheep-dog  take  to  tending  the  flock 
almost  of  his  own  accord.  Those  characters  have 
undoubtedly  been  acquired  by  the  ancestors  of  the 
puppies  and  been  handed  down  from  generation  to 
generation  until  they  have  become  a  part  and  parcel 


ACQUIRED  CHARACTERS.  43 

of  their  nature.  The  habits,  education,  and  mode  of 
life — the  environment  in  fact,  has  brought  about 
changes  in  the  animal's  organism,  and  these  changes, 
which  must  of  necessity  be  very  slight  in  the  first  case, 
are  transmitted  to  the  progeny.  With  each  generation 
the  changes  are  deepened  by  persistence  in  the  peculiar 
mode  of  life,  and  in  the  course  of  a  few  generations 
we  have  a  stock  of  animals  which  take  to  a  particular 
work  "  instinctively."  The  offspring  have  not  inherited 
any  part  of  the  education  of  their  ancestors,  but  they 
have  inherited  their  organisation  as  modified  by  their 
peculiar  mode  of  life:  in  other  words,  they  have 
inherited  a  strong  predisposition  toward  the  ways  of 
their  progenitors,  just  as  a  child  inherits  a  predisposi- 
tion to  the  ways  of  its  ancestors.  As  well  might  we 
expect  the  daughter  of  the  costermonger  to  take  on 
the  modesty  and  gentleness  and  tenderness  of  nature 
which  stamps  the  daughter  of  the  family  noted  for 
these  virtues  for  generations,  as  to  find  the  qualities  of 
the  sheep-dog  in  the  terrier,  or  those  of  the  greyhound 
in  the  bull-dog. 

And  if  this  be  so — if  it  be  true,  as  we  believe  it  is 
— that  all  characters  acquired  have  an  effect  upon  the 
offspring,  how  careful  should  each  one  be  not  to  do 
anything  which  may  leave  a  stain  upon  posterity. 
"  The  evil  that  a  man  does  lives  after  him  " — lives  not 
merely  as  the  poet  meant  it,  in  the  minds  of  other 
men,  or  upon  the  blotted  page  of  a  wasted  life.  There 
it  does  live ;  but  if  we  wish  to  know  it  all,  let  us  read 
it  in  the  lives  of  his  unfortunate  children. 


CHAPTER  IV. 

REVERSION. 

THIS  tendency  to  revert  or  "  throw  back "  to  the 
original  stock  is  a  wise  provision  of  Nature.  It  acts 
as  a  corrective.  It  is  the  genealogical  gardener  who 
keeps  a  watchful  eye  upon  all  distorted  offshoots, 
brings  them  into  proper  line  or  lops  them  off,  and  so 
keeps  the  family  tree  shapely  and  free  from  glaring 
deformity.  Were  it  not  for  this  law  of  reversion  all 
those  extreme  variations  from  the  true  family  type, 
however  hideous  or  useless,  which  from  time  to  time 
arise  from  some  extraordinary  action  of  the  environ- 
ment or  unhappy  blending  of  parental  characters,  or 
both,  might  be  repeated  and  exaggerated  indefinitely, 
even  till  the  true  type  of  the  family  would  be  lost  in 
a  crowd  of  mongrels  and  monsters.  Of  course  the 
action  of  the  environment  would  not  tolerate  this,  and 
so  the  family  would  become  extinct. 

When  the  individual,  from  whatever  cause,  varies  so 
far  from  the  present  existing  type  of  his  family  as  to 
be  out  of  harmony  with  it,  he  must  also  be  out  of 
harmony  with  his  environment,  for  the  family  type 
is  the  resultant  of  the  survival  of  the  fittest,  which 


REVERSION.  45 

means  those  in  most  perfect  harmony  with  the  en- 
vironment. And  as  the  creature  cannot  survive  long 
in  an  environment  to  which  he  is  not  suited,  there- 
fore the  offspring  of  the  extreme  variation  from  the 
normal  must  of  necessity  return  to  the  original  family 
type,  or  cease  to  exist  because  of  its  unfitness. 

When  these  extreme  variations  appear,  as  they  do 
in  a  wholly  unaccountable  manner  from  time  to  time, 
this  law  of  reversion  comes  into  action  and  is  not  in- 
frequently successful  in  bringing  back  the  wanderer; 
but  should  it  fail  in  doing  so  the  extreme  variety 
cannot  be  continued,  either  there  will  be  no  offspring, 
or  if  there  be  it  will  prove  sterile.  Thus  the  continu- 
ance of  the  grossly  unfit  becomes  impossible.  When 
variation  is  extreme,  reversion  or  extinction  must 
take  place,  and  whether  reversion  or  extinction  is  to 
be  the  verdict  of  Nature,  depends  to  a  great  extent 
upon  the  conduct  of  the  individual  representing  the 
variety.  If  he  or  she  join  with  another  of  the  same 
variety  for  the  continuance  of  the  race,  there  will 
probably  be  no  offspring,  or  if  there  be  it  will  prove 
sterile  =  extinction ;  while  if  he  or  she  join  with  a 
normal  fellow,  or  one  belonging  to  a  different  variety, 
Nature  will  seize  upon  the  opportunity  offered  by 
the  infusion  of  fresh  blood,  and  in  the  offspring 
"  throw  back "  to  the  old  family  type  =  reversion. 
And  this  law  is  equally  active  whether  the  variation  be 
physiological  or  pathological.  It  is  impossible  to  con- 
tinue a  family  all  idiots,  or  dwarfs,  as  it  is  impossible 
to  continue  one  all  giants,  or  geniuses.  The  individual 


46  MARRIAGE  AND  DISEASE. 

presenting  extreme  variation  from  the  normal  cannot 
continue  his  like,  and  were  it  not  for  this  law  of  reversion 
the  offspring  of  all  such  must  succumb. 

Although  this  law  is  continually  in  action,  guarding 
jealously  the  family  type  against  gross  contamination, 
its  action  is  most  commonly  only  observed  in  those 
cases  in  which  the  variation  from  the  normal  is 
marked.  Should  the  variation  be  only  slight  this 
principle  of  reversion  is  less  active,  the  new  character 
is  often  transmitted  in  such  cases,  and  in  the  course 
of  some  generations  may  become  a  fixed  and  constant 
character  in  the  family.  In  this  way  new  varieties 
and  races  are  built  up.  But  should  the  variation  be 
extreme,  whether  recent  and  unstable,  the  result  of 
some  inharmonious  action  of  the  various  influences 
at  work,  or  the  outcome  of  several  generations  of  in- 
judicious breeding,  Nature  revolts  against  the  innova- 
tion and  throws  back  to  the  original. 

Of  the  working  of  this  law  of  reversion  we  have 
proof  on  every  hand.  If  we  take  a  person  belonging 
to  some  decidedly  abnormal  variety,  as,  say,  the  giant 
(physiological),  or  the  deeply  phthisical  (pathological), 
we  shall  see  how  it  acts.  If  either  of  these  marry  one 
belonging  to  the  same  abnormal  type  as  himself,  there 
will  either  be  no  offspring,  or,  if  there  be,  it  will  show 
a  marked  tendency  to  perpetuation  of  the  abnormality 
of  the  parents,  and  this  deepening  with  each  genera- 
tion, the  necessarily  fatal  type  will  soon  be  reached 
and  the  family  be  at  an  end.  Here  with  the  junction 
of  Like  abnormal  persons,  the  law  of  reversion  has  little 


REVERSION.  47 

chance  of  coming  into  action,  and  the  only  other 
mode  of  putting  an  end  to  an  unfit  family — extinction 
— is  called  upon.  Thus  the  intermarriage  of  dwarfs 
or  giants  is  seldom  fruitful,  while  the  children  of 
parents  both  of  whom  suffer  from  scrofula,  insanity, 
epilepsy,  &c.,  of  a  well-marked  type  are  generally 
carried  off  in  infancy,  die  before  the  procreative  period 
is  reached,  or  are  sterile.  But  the  result  is  very 
different  if  the  diseased  or  otherwise  abnormal  one 
marry  a  person  belonging  to  some  other  variety  than 
his  own,  as  the  phthisical  the  robust,  or  the  giant  or 
dwarf  one  of  ordinary  stature.  Here  the  law  of  re- 
version comes  into  play,  and  in  the  offspring  of  such 
unions  there  is  a  great  effort  made  to  "  throw  back " 
to  the  original  stock,  that  is,  in  the  examples  we  have 
taken,  the  fairly  healthy  and  the  mediocre  in  stature 
respectively. 

Hence  we  have  the  rule,  that  the  offspring  of  indi- 
viduals of  different  varieties  tends  strongly  to  throw 
back  to  the  normal,  while  the  offspring  of  parents 
belonging  to  the  same  variety  tends  to  retain  the 
peculiar  characters  of  that  variety,  and  when  the 
characters  become  extreme  the  stock  dies  out.  This 
rule  is  well  known  to  breeders  of  animals,  who  will 
tell  you  that  breeding  "  in  and  in,"  that  is,  breeding 
from  animals  belonging  to  the  same  variety,  will  per- 
petuate, and  in  time  accentuate  the  peculiar  qualities 
of  the  variety,  be  they  good  or  bad,  while  "  crossing," 
which  means  breeding  from  animals  belonging  to 
different  varieties,  will  reduce  the  characters  peculiar 


48  MARRIAGE  AND  DISEASE. 

to  either  parent,  and  the  offspring  will  revert  to  the 
original  stock. 

It  must  here  be  pointed  out  that  in  thus  referring 
to  reversion  to  the  healthy  type  as  following  the  inter- 
marriage of  individuals  belonging  to  different  varieties, 
all  degenerate  conditions  must  be  taken  as  belonging 
to  the  same  variety.  The  more  closely  such  degenerate 
conditions  as  epilepsy,  insanity,  scrofula,  drunken- 
ness, cancer,  and  crime  are  inquired  into,  the  clearer 
it  becomes  that  they  are  not  only  related,  but  that 
they  are  largely  interchangeable.  For  this  reason  the 
intermarriage  of  so  apparently  unlike  temperaments 
as  the  cancerous  and  insane,  the  cancerous  and 
scrofulous,  or  the  insane  and  rheumatic,  seldom  or 
never  result  in  reversion  to  the  healthy  type.  Unions 
of  this  kind  are  almost,  if  not  quite,  as  dangerous  to 
the  offspring  as  those  of  individuals  belonging  to 
families  in  which  the  family  degeneration  has  taken 
exactly  the  same  outward  form. 

We  shall  see  later  that  such  apparently  distinct 
degenerate  characters  as  epilepsy,  insanity,  cancer, 
rheumatism,  gout,  and  scrofula,  are  in  reality  but  the 
varying  outward  signs  of  a  common  constitutional 
depravity,  and  that  they  constantly  replace  one  another 
in  succeeding  generations  of  the  deteriorating  family, 
and  even  in  different  members  of  the  same  generation. 

The  following  family  history  of  a  patient  of  my  own 
is  a  good  example  of  how  the  outward  signs  of  family 
nnfitness  may  vary  in  the  different  members  of  the 
family : — 


lags 

Mi 


w 
Sa 


]M 

M 


8 


®  3 

-1! 

li 


50  MARRIAGE  AND  DISEASE. 

Here,  in  the  family  of  this  cancerous  man — whose 
brother  was  a  suicide — and  neurotic  woman,  we  have 
the  innate  degeneracy  showing  itself  in  the  seven  chil- 
dren as  cancer,  consumption,  epilepsy,  infantile  con- 
vulsions, insanity,  want  of  development,  and  sterility. 
Two  of  the  children  happily  succumbed  before  maturity 
was  reached,  and  of  the  remaining  five  three  were 
sterile,  two  consumptive,  one  epileptic  and  insane,  and 
one  cancerous.  Only  one  has  until  now  escaped  the 
family  blight,  but  as  he  may  yet  develop  insanity, 
cancer,  or  some  other  disease  degeneration,  it  cannot 
be  said  that  even  one  of  the  whole  family  reverted  to 
the  healthy  type.  So  far  as  we  know,  the  taint  in  the 
mother  was  not  deep,  yet  apparently  its  presence  was 
sufficient  to  ensure  the  transmission  of  the  degenerate 
type  by  rendering  reversion  to  the  normal  impossible. 
Had  this  woman  belonged  to  a  healthy  family,  there 
can  be  little  doubt  that,  notwithstanding  the  deeply 
degenerate  father,  reversion  to  the  healthy  would  have 
occurred  in  some  of  the  children — at  all  events,  the 
chances  of  such  reversion  taking  place  would  have 
been  vastly  increased. 

Many  other  cases  might  be  given  like  the  above. 
That  quoted  from  Dr.  B.  W.  Richardson  at  page  185  is 
instructive.  There  the  intermarriage  of  the  cancerous 
and  consumptive  temperaments  resulted  in  the  destruc- 
tion of  every  child  by  one  or  other  of  these  diseases. 

From  what  has  been  said  it  should  be  clear  that, 
notwithstanding  this  law  of  reversion,  it  is  possible  to 
alter  the  family  type  considerably,  if  only  sufficient 


REVERSION.  51 

time  be  given  to  let  the  new  character  gain  some 
fixity.  Thus,  although  we  cannot  breed  a  race  of 
actual  giants  or  geniuses,  we  can  in  time  materially 
increase  or  diminish  the  mental  or  physical  stature, 
and  so  long  as  the  modification  be  not  so  radical  as 
to  be  out  of  harmony  with  the  environment,  there  ia 
little  increased  danger  of  extinction ;  while,  if  the  pro- 
cess be  sufficiently  gradual,  there  will  be  little  danger, 
after  a  few  generations,  of  reversion.  The  truth  of 
this  as  applied  to  physical  characters  is  well  known. 
Breeders  of  animals  act  upon  it  constantly,  and  await 
the  result  with  perfect  confidence.  It  is  not,  however, 
so  generally  recognised  as  applicable  to  the  moral  and 
mental  characters,  and  for  this  reason  I  shall  take  an 
example  from  the  latter  class.  Let  us  take  the  mathe- 
matical, or,  say,  the  financial  quality  of  mind,  which, 
when  strongly  developed,  constitutes  a  physiological 
variation.  This  variation  is  often  the  result  of  some 
happy  blending  of  parental  characters,  mediocre  in 
themselves.  In  such  cases  it  is  a  newly  acquired 
character  having  no  fixity.  The  father  or  the  mother 
of  the  great  financier  has  seldom  or  never  displayed 
the  mental  character  which  so  strongly  marks  their 
child,  just  as  the  poet  or  the  orator  is  seldom  the 
child  of  a  poet  or  an  orator.  If,  then,  the  great 
financier  marries  a  woman,  brilliant,  it  may  be,  in 
other  ways,  but  having  none  of  his  peculiar  quality  of 
mind,  the  offspring  will  in  all  likelihood  revert  to  the 
normal  stock,  and  display  little,  perhaps  very  little,  of 
the  father's  peculiar  ability.  Here  the  new  character 


52  MARRIAGE  AND  DISEASE. 

has  gained  no  fixity,  and,  the  mother  not  belonging  to 
the  same  variety,  the  offspring  "  throws  back  "  to  the 
original.  Even  had  the  mother  possessed  something 
of  this  mental  quality,  the  result  would  probably  have 
been  the  same  (though  the  chances  of  reversion  would 
have  been  lessened),  for  the  reason  that  the  stride  from 
the  average  mental  development  to  that  of  the  mathe- 
matical genius  is  too  great  for  Nature.  Had  the  father's 
peculiar  mental  character  been  less  marked,  and  more 
especially  had  it  been  the  outcome  of  many  generations 
of  building  up,  as  it  is  in  the  case  of  the  Jew,  there 
would  have  been  very  little  tendency  to  reversion,  and 
the  children  would  almost  certainly  have  inherited  it. 
In  the  Jew  the  character  has  become  fixed ;  by  repeated 
transmission  through  generations  it  has  become  a  stable 
and  constant  family  character,  and  even  if  the  Jew 
were  to  marry  a  woman  belonging  to  a  different  variety, 
yet  would  the  children  inherit  the  character.  This 
mental  character  has  been  so  ingrained  in  the  Jew  by 
continual  cultivation,  and  by  intermarriage  with  those 
of  his  own  race,  nearly  all  of  whom  cultivate  the  char- 
acter, that  it  would  take  many  "  crossings  "  to  efface 
it ;  whereas  the  same  character,  even  in  a  much  higher 
degree  of  development,  as  it  occurs  sometimes  in  the 
great  financiers  of  other  races,  is  but  the  outcome  of 
some  happy  combination  of  parental  characters,  and 
having  no  stability,  we  look  in  vain  for  its  continuance 
in  the  offspring. 

A  point  of  still  greater  importance  to  us,  is  the  fact 
that  this  principle  of  reversion  to  the  normal  is  as 


REVERSION.  53 

active  and  efficacious  in  the  case  of  disease  as  in  other 
variations — as  effectual  in  calling  back  the  pathological 
wanderer  to  the  true  path  as  it  is  in  the  case  of  the 
physiological;  and  here  lies  our  greatest  hope.  It  is 
the  most  cheering  fact  met  with  in  the  study  of  heredity. 
Here  we  have  Nature  standing  by  our  side,  ever  ready 
to  assist  us  in  any  effort  we  may  make  to  purify  the 
race.  Disease  is  but  "the  sins  of  the  father  visited 
upon  the  children,"  and  if  we  will  but  make  an  effort 
to  clear  ourselves  of  the  stain,  Nature,  ever  kind,  will 
go  hand  in  hand  with  us,  and  aid  us  at  every  step  in 
our  good  work. 

Disease  is  foreign  to  Nature — it  is  an  acquired  char- 
acter ;  and  from  the  fact  that  when  transmitted  it  so 
soon,  in  most  cases,  attains  the  necessarily  fatal  form, 
it  can  never  have  much  fixity.  Consequently,  in  all 
cases  in  which  the  disease  has  not  already  gained  too 
great  a  hold,  on  the  infusion  of  untainted  blood  rever- 
sion to  the  normal,  i.e.,  healthy,  is  the  rule.  In  this 
connection,  because  of  its  healing  or  cleansing  effect, 
reversion  has  been  called  the  vis  medicatrix  natures, 
and  it  is  of  incalculable  assistance  to  us  in  any  efforts 
of  ours  to  exterminate  hereditary  disease.  But  it 
cannot  overbear  the  laws  of  hereditary  transmission. 
If  the  scrofulous  will  marry  the  scrofulous,  and  the 
insane  the  insane,  this  benign  law  is  powerless,  and  the 
diseased  family,  going  from  bad  to  worse,  must  become 
extinct.  But  if  man  will  not  ignore  and  try  to  over- 
ride the  laws  of  Nature,  which  he  can  only  ignore  at 
his  own  cost,  and  which  he  can  never  over-ride — if  he 


54  MARRIAGE  AND  DISEASE. 

will  give  a  tithe  of  the  attention  to  the  laws  of  heredi- 
tary transmission  in  the  production  of  his  children  that 
he  does  in  the  production  of  every  other  animal  over 
which  he  has  control,  this  vis  medicatrix  naturae  will 
assist  him,  and  he  may  hope  soon  to  have  the  human 
family  as  free  from  hereditary  disease  and  imperfec- 
tion as  are  the  animals  in  Nature.  If  man  would  only 
do  his  part  in  this  great  work,  Nature  could  be  safely 
reckoned  upon  to  do  hers. 

Let  us  have  a  simple  example  of  the  working  of  this 
vis  medicatrix  natures.  If,  in  place  of  the  financier, 
who  was  a  physiological  variation  from  the  normal,  we 
take  the  epileptic,  or  the  man  of  insane  temperament, 
who  represents  a  pathological  variation,  we  shall  find 
that  the  same  rule  applies.  If  this  man  marry  a  person 
of  the  same  abnormal  type  as  himself,  that  is,  a  mem- 
ber of  some  highly  neurotic  family,  the  offspring  will 
inherit  the  predisposition  or  liability  to  insanity  more 
strongly  than  that  present  in  either  father  or  mother, 
and  its  chance  of  passing  through  life  without  becom- 
ing insane  will  be  markedly  less  than  that  of  either 
parent.  But  if  he  marry  a  woman  far  removed  from 
the  neurotic  or  insane  type,  the  children  will  in  all 
probability  inherit  their  father's  abnormal  quality  but 
slightly,  and  their  liability  to  madness  will  be  decidedly 
less  than  his  own;  that  is,  the  children  will  ''throw 
back"  to  the  healthy  type.  And  as  it  is  with  mental 
or  nervous  disease,  so  it  is  with  physical  We  know, 
for  example,  how  the  phthisical,  and  gouty,  and  scro- 
fulous, and  rheumatic  temperaments  can  be  and  are 


REVERSION.  55 

increased:  or  'diminished  in  point  of  gravity  at  every 
generation  by  marriage  into  healthy  or  tainted  families, 
and  how  a  disease  which  has  "run  in  a  family"  for 
several  generations  is  sometimes  stamped  out  by  a 
few  judicious,  if  chance,  "  crossings."  Amongst  the 
domestic  animals  such  crossings  are  judicious,  they  are 
the  outcome  of  thought  and  careful  attention,  and  we 
know  how  rapidly  effective  they  are  for  good.  Unfor- 
tunately, in  the  case  of  man,  when  they  do  occur,  they 
are  in  nearly  every  case  the  result  of  chance. 

Nature  is  ever  more  ready  to  assist  the  doer  of  good 
than  the  evil-doer,  and  if  men  and  women  would  but 
spend  a  thousandth  part  of  the  time,  trouble,  and 
wealth,  with  a  view  to  the  improvement  of  the  gene- 
rations yet  to  come,  that  they  do  to  encumber  their 
estates,  the  amount  of  human  suffering  would  be 
vastly  reduced,  and  the  world  would  be  much  healthier 
and  happier  than  it  is.  But  so  long  as  men  and  women 
will  set  the  hectic  flush  above  the  ruddy  glow  of  health, 
consider  curve  of  lip  or  eyebrow  of  more  importance 
than  mental  power  or  moral  worth,  prefer  length  of 
purse  and  social  rank  to  the  happiness  of  their  children, 
let  sickly  sentiment  take  the  place  of  reason,  "  wilfully 
frustrate  the  noble  purposes  of  their  being,  and  selfishly 
ignore  the  laws  of  hereditary  transmission,"  so  long 
shall  the  unfit  be  begotten,  hereditary  disease  flourish, 
and  immense  avoidable  suffering  continue  in  the  world 
as  the  sins  of  the  fathers  and  mothers  are  visited  upon 
the  innocent  children. 


CHAPTER  V. 

PREPOTENCY   IN   CHARACTERS. 

THIS  principle  of  prepotency  in  heredity  may  be  said 
to  act  in  opposition  to  that  of  reversion,  and  so  render 
the  building  up  of  new  races  and  varieties  possible. 
Reversion  is  conservative ;  it  tends  to  stamp  out  all 
new  characters  and  to  continue  the  race  as  it  is,  or 
was,  while  the  principle  of  prepotency  permits  the 
new  character  to  acquire,  in  time,  strength  and  fixity 
sufficient  to  resist  the  action  of  reversion,  and  ensure 
the  transmission  of  the  new  character  to  the  next 
generation. 

When  speaking  on  the  subject  of  heredity,  many 
take  it  as  a  fact  that  all  characters  in  the  parental 
economy  are  equally  potent,  and,  consequently,  stand 
an  equal  chance  of  being  transmitted  to  the  offspring. 
But  such  is  certainly  not  the  case.  We  have  already 
seen  that  recently  acquired  characters  are  not  trans- 
mitted with  the  same  certainty  that  those  of  long 
standing  are.  At  first,  before  the  new  character  has 
become  deeply  impressed  upon  the  animal  organism, 
there  is  a  very  great  liability  on  the  part  of  the  off- 
spring to  revert  to  the  status  quo  ante;  but  with  each 


PREPOTENCY  IN  CHARACTERS.       57 

generation  this  liability  to  reversion  lessens,  as  the 
acquired  character  becomes  more  firmly  fixed.  Thus 
with  every  transmission  a  character  becomes  more 
firmly  fixed ;  but  to  secure  such  repeated  transmission 
of  a  new  character,  it  is  necessary  that  each  genera- 
tion should  live  under  conditions  very  slightly  re- 
moved from  those  under  which  the  character  was 
originally  acquired,  and  also,  that  for  a  time  at  least 
there  should  be  no  "crossing;"  for,  with  a  changed 
environment,  or  with  a  distinct  "cross,"  there  will 
be  reversion,  and  the  character  will  be  lost.  Hence 
the  character  of  long  descent  is  the  result,  not  alone 
of  "  in  and  in "  breeding,  but  of  this,  carried  on  in  an 
environment  very  similar  to  that  in  which  the  char- 
acter first  made  its  appearance. 

The  peculiar  mental  character  of  the  Hebrew,  of 
which  we  have  spoken,  may  here  be  taken  as  an 
example.  It  was,  in  the  first  place,  the  outcome  of  a 
certain  condition  of  environment,  that  is,  the  pecu- 
liar mode  of  life  followed.  Then  it  was  deepened  and 
strengthened,  given  a  prepotency,  by  intermarriage 
with  other  individuals  who  had  existed  in  the  same 
environment  and  who  had  also  acquired  the  character ; 
and  it  has  been  preserved  and  fixed  in  the  race  by 
continued  intermarriage  and  by  a  continuance  of  the 
environment  which  first  called  it  into  existence,  viz., 
the  mode  of  life. 

So  in  every  individual,  or  rather  in  every  family, 
there  are  certain  characters  which  stand  out  pro- 
minently amongst  the  myriads  of  others  inherited, 


58  MARRIAGE  AND  DISEASE. 

and  give  tone  or  bent  to  the  whole.  Of  the  innumer- 
able characters  inherited  by  the  child,  some  are  recently 
acquired  by  the  family,  and  are  but  slightly  developed 
and  still  more  slightly  fixed;  others,  even  of  long 
standing,  are  fading  from  want  of  cultivation,  or  from 
some  change  in  the  environment ;  while  others,  again, 
are  prominent  or  strongly  marked,  not  from  long 
descent  alone,  but  from  this  coupled  with  continued 
cultivation,  i.e.,  by  intermarriage  among  persons  of 
the  same  variety  in  an  environment  favourable  to  the 
continuance  of  the  character.  In  fact,  prepotency  is 
another  name  for  fixity,  and  fixity  of  a  character  is 
only  to  be  secured  by  repeated  transmission;  which, 
in  turn,  is  only  to  be  gained  by  "  in  and  in  "  breeding 
in  as  nearly  constant  an  environment  as  is  attainable. 
Breeders  of  animals  use  the  word  "fixity"  in  this 
sense.  When  they  have  succeeded  by  repeated  judicious 
"  crossing "  in  obtaining  a  new  character,  which  they 
consider  valuable,  they  set  about  "fixing"  it,  which 
process  consists  in  maintaining  the  original  environ- 
ment as  nearly  as  possible,  and  permitting  no  "  cross  " 
of  fresh  blood.  When  by  these  means  the  new  char- 
acter has  been  transmitted  through  several  generations, 
the  character  is  said  to  be  "  fixed,"  that  is,  it  has  gained 
a  prepotency,  has  become  a  prominent  character  in  the 
animal  economy,  and  is  little  liable  to  be  lost  by  re- 
version. But  even  when  this  fixity  has  been  gained, 
if  it  is  desired  to  preserve  the  character,  it  is  necessary 
that  the  environment  should  not  be  radically  changed 
and  that  "  crossing  "  should  be  prevented ;  for  although 


PREPOTENCY  IN  CHARACTERS.  59 

a  well-fixed  character  may  defy  for  a  time  a  change 
of  environment,  or  one,  or  even  two  or  three  "  cross- 
ings," yet  it  will  assuredly  disappear,  should  either  of 
these  be  persisted  in.  In  the  "Southdown"  sheep, 
for  example,  certain  acquired  characters  have  been 
thus  securely  fixed;  yet  if  we  "cross"  the  "South- 
down" with  some  other  variety,  the  peculiar  char- 
acters of  the  former  will  soon  be  lost ;  and  similarly, 
if  the  animals  be  transferred  to  an  environment  widely 
differing  from  that  in  which  their  peculiar  characters 
were  acquired,  as,  say,  from  the  rich  English  pastures 
to  the  bleak  Welsh  mountains,  the  animals  will  throw 
off  the  acquired  characters  and  revert  to  the  original, 
or  acquire  new  characters  altogether. 

It  may  be  taken,  therefore,  that  the  longer  any 
character  has  "run  in  the  family,"  the  more  deeply 
is  it  rooted,  so  to  speak,  and  the  more  difficult  to 
eradicate.  And  the  character  which  has  been  handed 
down  through  many  generations  is  often  so  fixed  and 
dominant,  that  it  will  appear  again  and  again  in  spite 
of  repeated  "  crossings "  with  fresh  blood.  Hence 
the  gravity  of  an  hereditary  disease  is  by  no  means 
to  be  accurately  measured  by  the  symptoms  presented 
in  the  individual,  but  rather  by  the  number  of  genera- 
tions through  which  it  has  passed  to  reach  him ;  and 
the  risk  of  children  inheriting  such  diseased  condi- 
tions or  predisposition  as  lead  to  epilepsy,  scrofula, 
insanity,  drunkenness  and  the  like,  will  increase  pro- 
portionately with  the  number  of  generations  through 
which  the  tendency  has  been  handed  down.  Thus, 


60  MARRIAGE  AND  DISEASE. 

the  person  who  has  actually  been  insane  may  in  some 
cases  marry  with  far  less  risk  to  the  children  than 
many  other  persons  who  have  never  been  so.  For 
example,  the  man  whose  grandfather  and  father  have 
been  insane,  would  stand  a  much  greater  chance  of 
begetting  children  who  would  become  insane,  although 
he  had  never  shown  a  symptom  of  mental  disorder 
himself,  than  the  man  with  a  really  good  family 
history  whose  mind  had  given  way  under  pressure 
of  some  extraordinary  trial,  mental  or  physical,  and 
who  was  some  time  recovered.  In  the  first  case  the 
character  has  gained  prepotency  from  repeated  trans- 
mission, and  even  with  a  perfectly  healthy  wife,  the 
chance  of  reversion  is  not  nearly  so  great  as  in  the 
second,  where  the  character  being  recently  acquired 
and  having  no  fixity  will  probably  disappear,  more 
especially  if  the  wife  be  healthy,  and  the  exceptional 
state  of  environment  which  developed  the  character 
be  removed. 

Fortunately,  there  are  very  few  diseased  conditions 
in  which  we  can  cite  instances  of  prepotency,  as  these 
pathological  variations,  when  continued,  soon  reach 
the  necessary  fatal  type  and  put  an  end  to  the  family. 
For  this  reason  hereditary  disease  is  seldom  sufficiently 
firmly  fixed  as  to  be  able  to  resist  the  natural  tendency 
to  reversion  to  the  healthy  type,  if  opportunity  be 
offered  by  marriage  with  the  healthy.  And  for  the 
same  reason  it  is  rarely,  even  in  the  most  deeply 
tainted  families,  that  we  find  the  pathological  family 
character  reproduced  in  all  the  children.  In  some 


PREPOTENCY  IN  CHARACTERS.  61 

it  is  almost  certain  to  appear,  but  it  rarely  attacks 
every  child,  for  the  reason  that  before  the  predis- 
position to  disease  has  gained  sufficient  fixity  in  the 
family  to  accomplish  this,  the  family  is  extinct.  Thus 
the  end  of  insanity  regularly  transmitted  in  a  family 
is,  as  Morel  has  shown,  sterile  idiocy.  Inter- marriage 
of  those  in  whom  the  liability  to  phthisis  is  extreme, 
though  often  fruitful,  seldom  enriches  posterity.  The 
children  of  the  deeply  scrofulous  are  mostly  carried 
off  in  infancy  and  childhood,  or  drag  out  a  miserable 
existence,  the  inmates  of  idiot  and  imbecile  asylums. 
Epilepsy  and  drunkenness  lead  to  early  and  violent 
deaths,  insanity,  idiocy,  and  extinction,  while  the 
instinctive  criminal  is  the  unfortunate  representative 
of  a  decaying  race.  In  these  cases  the  predisposi- 
tion to  disease  has  taken  such  hold  upon  the  organism, 
that  the  opportunity  offered  for  reversion  is  not 
sufficient  to  induce  that  desirable  change.  The  in- 
dividual is  brought  forth  un suited  to  his  surround- 
ings, and  consequently  succumbs.  That  equilibrium 
between  creature  and  environment  of  which  we  have 
spoken  has  been  lost,  and  a  continuance  of  the  family 
has  become  impossible. 

Nevertheless,  there  are  some  hereditary  diseases 
which  are  handed  down  through  a  sufficient  number 
of  generations  to  gain  a  considerable  prepotency.  The 
first  among  these  is  gout;  rheumatism  is  another  in 
which  prepotency  is  often  attained.  In  some  families 
gout  has  gained  such  fixity,  that  it  appears  in  almost 
every  member  of  the  male  line,  generation  after  gene- 


62  MARRIAGE  AND  DISEASE. 

ration,  and  this  is  to  be  accounted  for  by  the  fact  that 
although  gout  entails  considerable  suffering  upon  its 
victims,  it  rarely  proves  fatal  until  long  after  the 
procreative  period  has  been  reached.  The  untainted 
blood  introduced  from  time  to  time  is  rarely  sufficient 
to  rid  the  family  of  the  disease,  because  the  mode  of 
life  which  first  induced  the  abnormal  condition  is 
persisted  in.  Here  we  have  a  good  example  of  the 
action  of  a  constant  environment  acting  in  opposition 
to  the  principle  of  reversion.  "When  the  man  who 
has  inherited  gout  marries  a  member  of  a  healthy 
family,  the  vis  medicatrix  naturae  has  only  half  a  chance, 
so  to  speak,  for  while  the  introduction  of  untainted 
blood  offers  opportunity  for  reversion  in  the  offspring 
to  the  healthy  type,  the  man  rarely  changes  his  mode 
of  life,  that  is,  the  environment  favourable  to  the 
abnormal  character  continues,  and  so  the  pathological 
variation  is  transmitted,  mitigated,  it  may  be,  by  par- 
tial reversion  in  consequence  of  the  "  cross,"  but  still 
sufficiently  potent  to  ensure,  with  the  aid  of  the 
constant  environment,  its  reappearance  in  the  next 
generation.  Like  every  other  hereditary  disease,  gout 
is  a  degeneration,  and  although  it  often  runs  long  in 
a  family,  there  can  be  no  doubt  that  if  the  environment 
favourable  to  it  be  maintained,  it  will  ultimately 
attain  the  necessarily  fatal  type,  and  it  is  certain 
that  to  this  hereditary  degeneration  must  be  attributed 
the  extinction  of  many  branches  of  our  aristocratic 
and  well-to-do  families. 

But  it  is  not  among  the  rapidly  fatal  class  of  hereditary 


PREPOTENCY  IN  CHARACTERS.       63 

characters  that  we  must  look  for  the  most  convincing 
proof  of  the  theory  that  a  character  gains  prepotency 
with  age.  Here  we  do  at  times  find  cases  to  support 
the  theory,  but  it  is  amongst  those  less  grave  characters 
which,  while  unmistakably  marked,  do  not  so  rapidly 
go  to  the  extinction  of  the  family  that  we  must  find 
our  strongest  proof,  among  such  characters  as  hare-lip, 
cleft-palate,  club-foot,  squint,  cataract,  supernumerary 
fingers  or  toes,  colour-blindness,  premature  baldness 
or  greyness,  deaf-mutism,  stammering,  plurality  of 
births,  the  hsemorrhagic  diathesis  (bleeders),  spina 
bifida,  and  the  like ;  or,  on  the  other  hand,  where  the 
character  is  physiological.  Instances  of  repeated  trans- 
mission of  any  or  all  of  the  above-mentioned  characters 
can  be  found  everywhere  around,  and,  doubtless,  cases 
will  present  themselves  to  the  mind  of  the  reader. 
It  is  possible  such  imperfections  may  appear  in  a 
family  in  which  they  have  never  appeared  before, 
but,  in  such  cases,  if  the  individual  bearing  the 
character  marry  one  having  no  tendency  to  such  char- 
acters, the  acquired  imperfection  will  not  appear  in 
the  next,  or  in  succeeding  generations.  In  all  families 
in  which  these  abnormal  developments  are  regularly 
transmitted,  inquiry  will  elicit  the  fact  that  the  char- 
acter has  appeared  regularly  in  the  family  as  far 
back  as  there  is  any  record  of  the  family.  A  very 
good  case  in  point  is  that  recorded  by  Dr.  W.  C.  Grigg.* 
He  says — "  I  was  consulted  by  a  Mrs.  M.  B.,  a  Wiltshire 
woman,  aged  forty-four,  who  gave  me  this  history 

*  Brit.  Med.  Journal,  8th  March  1890. 


64  MARRIAGE  AND  DISEASE. 

of  her  family :  Great  grandmother,  maternal  side,  had 
nine  children  at  three  births,  triplets  each  time.  Grand- 
mother had  seven  children,  triplets  once,  twins  twice. 
Her  mother  had  twelve  children,  once  triplets,  twice 
twins,  five  single  births.  Her  mother's  sister  had 
seven  children,  triplets  once,  four  single  births.  Her 
mother  and  her  aunt  married  two  brothers.  Her 
mother  had  two  brothers  who  married;  neither  had 
children.  Mrs.  M.  B.  has  had  sixteen  children,  triplets 
twice,  ten  single  births.  She  has  seven  girls  living. 
Eldest  daughter  aged  twenty-five,  married,  has  four 
children,  one  triplet,  one  single  birth.  Second  daughter 
married  September  1889,  pregnant.  She  states  that 
she  herself  is  one  of  a  twin,  and  her  mother  also.  Her 
family  seems  to  be  well  known  in  the  village  whence 
she  comes  as  the  '  triplet  and  twin  family.'  Her 
maternal  great-aunt,  aged  ninety,  single,  is  still  living, 
who  declares  that  her  grandmother  told  her  that  her 
grandmother  informed  her  triplets  were  in  the  family 
as  far  back  as  any  record  could  be  obtained." 

Another  example  of  prepotency  of  a  physiological 
character  is  the  oft-cited  case  of  the  reigning  family  of 
Austria,  in  which  a  markedly  peculiar  facial  character 
— the  Hapsburg  lip — has  been  transmitted  with  marvel- 
lous certainty  through  a  great  number  of  generations, 
apparently  too  firmly  fixed  to  be  eradicated  or  even 
modified  by  the  infusion  of  fresh  blood  which  occurs 
with  almost  each  generation.  In  this  case  the  peculiar 
character  doubtless  arose  from  some  accidental  cir- 
cumstances, and  by  unpremeditated  selection  became 


PREPOTENCY  IN  CHARACTERS.       65 

fixed  so  that  it  was  transmitted  again  and  again, 
gaining  in  fixity  with  each  successive  transmission. 

The  strongest  proof  of  all,  however,  of  the  fixity  or 
prepotency  gained  by  long  descent,  is  to  be  found  in 
reversion.  When  a  character  is  lost  in  consequence 
of  reversion,  it  is  nearly  always  a  more  or  less  recently 
acquired  one,  while  that  which  appears  in  its  place 
is  invariably  an  old  family  one.  The  normal  type, 
which  reversion  does  its  best  to  reproduce,  is  made 
up  of  characters  which  have  run  in  the  family  for 
ages.  Acquired  characters  have  accumulated  in  the 
course  of  a  few  generations,  and  the  old  family  type 
seems  to  be  overborne  and  lost  in  the  new.  But  the 
lines  of  the  old  family  pattern  are  not  erased.  They 
lie  deep  down  in  the  organism  intact,  only  blurred 
or  hidden  by  the  recent  characters  overlying  them, 
and  ready  to  appear,  clear  and  distinct,  when  these 
latter  from  any  cause  are  brushed  aside. 

But  it  is  unnecessary  to  labour  the  point.  If  we 
accept  evolution,  I  think  we  must  accept  -the  theory 
of  prepotency  increasing  with  age  as  a  part  of  that 
doctrine.  Were  it  not  possible  for  a  character  to  be 
thus  fixed  by  repeated  transmission,  so  as  to  defy  the 
natural  tendency  to  reversion  to  the  original,  evolution 
would  be  an  impossibility,  and  all  that  has  been  built 
upon  it  must  tumble  to  the  ground. 

Thus  we  see  that  evolution  and  heredity  go  hand  in 
hand,  they  work  together,  they  are  inseparable.  Evo- 
lution modifies  the  individual  and  suits  him  to  his 
surroundings,  his  mode  of  life,  and  heredity  perpetuates 


66  MARRIAGE  AND  DISEASE. 

the  modification  in  his  descendants.  Were  it  not  so, 
every  change  in  the  individual,  brought  about  by 
education,  training,  and  mode  of  life,  must  of  necessity 
cease  to  exist  with  the  life  of  the  modified  individual, 
and  without  evolution,  heredity  could  only  reproduce 
the  one  changeless  type,  and  all  nature  would  be  at  a 
standstill.  Eibot  says : — "  These  modifications,  as  they 
accumulate  and  in  course  of  time  become  organic, 
make  new  modifications  possible  in  the  succession  of 
generations.  Thus  heredity  becomes  in  a  manner  a 
creative  power." 


CHAPTER  VI. 

THE   LAWS    OF   HEREDITY. 

WE  will  now  very  briefly  consider  the  so-called  laws 
of  heredity.  These  laws  are  not  based  on  any  very 
scientific  foundation,  but  they  are  nevertheless  most 
useful  when  we  leave  the  broad  theory  and  come  down 
to  the  very  interesting  study  of  individual  facts. 

The  following  live  "laws"  are  generally  given  as 
including  all  the  phenomena  of  descent. 

I.  Direct  Heredity. 
II.  Eeversional  Heredity  or  Atavism. 

III.  Collateral  or  Indirect  Heredity. 

IV.  Initial  Heredity. 

V.  Heredity  of  Influence. 

This  is  not  Kibot's,  or  the  usual  classification.  He 
omits  initial  heredity  altogether,  although  it  is  of 
the  utmost  importance,  and  has  perhaps  a  greater 
influence  upon  the  child  than  any  other  form  of 
heredity  excepting  only  the  direct,  of  which  it  is 
really  a  form. 

Let  us  now  glance  at  each  of  these  rules  or  laws,  and 
see  what  part  of  the  great  law  of  heredity  each  includes. 


68  MARRIAGE  AND  DISEASE. 

% 

I.  By  DIRECT  HEREDITY  is  meant  transmission  direct 
from  parent  to  child,  that  is,  where  there  is  least  inter- 
ference with  heredity  pure  and  simple,  and  the  child  is 
a  compound  of  its  parents.  Prepotency  may,  and  in 
fact  generally  does,,  come  into  play  here,  but  there  is 
a  marked  absence  of  variation  and  reversion. 

This  direct  heredity  is  generally  split  up  into  two 
sub- divisions,  thus  : — 

1.  Where   the    child    resembles    each   of   the  parents 
equally  in  its  moral,  mental,  and  physical  characters — 
in  fact,  where  the  child  is  an  exact  mean  of  its  parents. 
But,  as  we  have  already  seen,  this  result,  which  would 
be  a  realisation  of  the  ideal  law,  must  be  of  extreme 
rarity,  or,  if  we  wish  to  be  scientifically  correct,  an 
utter  impossibility,  for  to  ensure  an  exact  mean  in  the 
child  would  entail  a  perfectly  equal  blending  of  the 
parental  characters,  which  prepotency  can  seldom,  if 
ever,   allow,   together   with    a    constant   environment 
which  can  never  be  obtained.    We  do  occasionally  meet 
with  a  case  where  the  child  appears  to  be  as  nearly  as 
possible  a  mean  of  its  parents,  but  even  in  such  cases 
it  is  never  difficult  to  discover  that  the  mean  is  far 
from  perfect  or  exact.     For  this  reason  this  form  of 
direct  heredity  needs  no  consideration  at  our  hands. 

2.  Where  the  child,  being  a  compound  of  its  parents, 
resembles  one  parent  more  stronr/ly  than  the  other.     In 
most  cases  of  direct  heredity  the  child  resembles  some 
one  of  the  parents  much  more  strongly  than  the  other, 
and  this  is  only  what  we  would  expect  from  what  we 
have  already  learnt  of  prepotency.     But  although  the 


THE  LA  WS  OF  HEREDITY.  69 

child  may  show  little  or  no  trace  of  resemblance  to  one 
of  its  parents,  the  influence  of  that  parent  must  not  be 
taken  as  absent,  for  the  characters  peculiar  to  that 
parent  may  be  only  lying  latent  in  the  child,  ready  to 
appear  in  the  next,  or  some  more  remote,  generation. 
If  any  one  will  look  around  among  his  relatives  and 
friends  he  will  have  little  difficulty  in  discovering  cases 
in  proof  of  this,  such,  for  example,  as  where  a  son,  who 
apparently  in  no  way  resembles  his  mother,  begets 
daughters  in  whom  the  peculiar  characters  of  their 
grandmother,  although  absent  in  their  father,  are  re- 
produced with  striking  truthfulness.  But  this  will  be 
fully  considered  under  Eeversional  Heredity. 

In  direct  heredity  there  is,  then,  in  nearly  every 
case,  a  preponderance  of  resemblance  to  one  or  other  of 
the  parents,  and  this  preponderance  runs  in  two  ways. 
I.  Direct,  that  is,  from  father  to  son  and  mother  to 
daughter;. and  2.  Diagonally,  from  father  to  daughter 
and  from  mother  to  son.  Here  again  the  reader  will 
find  little  difficulty  in  discovering  families  which  will 
act  as  illustrations,  for  it  is  a  matter  of  common  remark 
that  in  some  families  the  sons  resemble  closely  the 
father  and  the  daughters  the  mother,  while  in  others 
the  sons  have,  as  a  rule,  a  peculiar  resemblance  to  the 
mother  and  the  daughters  to  the  father.  This  will  be 
more  easily  followed  in  cases  in  which  the  peculiar 
family  character  takes  the  form  of  some  gross  variation, 
as,  say,  epilepsy  or  scrofula.  In  such  cases,  if  the 
heredity  be  direct  and  the  father  be  the  parent  bearing 
the  taint,  the  sons  will  be  epileptic  or  scrofulous,  while 


70  MARRIAGE  AND  DISEASE. 

the  daughters  may  escape ;  and  if  the  mother  be  the 
affected  one,  while  the  sons  escape,  the  daughters  will 
be  epileptic  or  scrofulous  as  the  case  may  be.  But  if 
the  heredity  be  of  the  diagonal  order  the  epilepsy 
of  the  grandfather  will  descend  to  the  mother  and 
through  her  to  the  sons,  and  so  on,  appearing  in 
different  sexes  in  each  succeeding  generation. 

Of  these  two  the  direct  is  the  mode  of  transmission 
of  parental  characters  on  the  whole  the  more  commonly 
met  with,  the  sons  in  most  families  "  favouring "  the 
father,  and  the  daughters  the  mother ;  and  this  is  what 
we  might  expect.  But  there  are  some  family  characters 
which  are  said  to  be  much  more  commonly  transmitted 
by  the  diagonal  than  the  direct.  Among  such 
characters  are  physical  deformities  and  other  imperfec- 
tions of  development,  as  deaf-mutism,  hare-lip,  squint, 
club-foot,  supernumerary  digits  and  the  like.  But 
although  this  is  generally  accepted,  there  is  very  little 
evidence  to  support  it,  and  I  am  inclined  to  doubt 
whether  even  in  these  particular  cases  the  diagonal  is 
the  more  common  mode  of  transmission. 

In  support  of  this  view,  I  would  remark  that  such 
structural  peculiarities  as  have  been  mentioned  above, 
are  much  more  likely  to  prove  a  bar  to  marriage  in  the 
female  than  in  the  male,  and  as  these  deformities  are 
as  frequently — if  not  more  frequently — met  with  in  the 
male,  therefore  they  must  in  a  majority  of  cases  be 
conveyed  by  direct  heredity  from  the  father  to  the  sons. 
Besides,  such  peculiarities  being  a  very  slight  bar  to 
marriage  in  the  male,  they  are  consequently  more  likely 


THE  LAWS  OF  HEREDITY.  71 

to  be  handed  down  through  many  generations  in  the 
male  line  than  in  the  female,  and  must  thus  by  repeated 
transmission  gain  a  prepotency  in  the  male  line. 

A  good  example  of  structural  peculiarity  transmitted 
generation  after  generation  in  the  same  sex,  or  directly, 
is  the  facial  peculiarity  seen  in  the  present  reigning 
family  of  Austria,  "the  Hapsburg  lip"  of  which  we 
have  already  spoken,  which  has  been  handed  down 
along  the  male  line  for  a  considerable  number  of 
generations,  seldom  appearing  in  the  female  members 
of  the  family,  and  apparently  but  slightly  influenced 
by  the  new  female  blood  introduced  with  almost  every 
generation.  A  still  more  peculiar  case  was  that  of 
Edward  Lambert,  "  the  human  porcupine,"  as  he  was 
called ;  this  man's  skin  was  covered  by  warty  projec- 
tions which  were  periodically  moulted.  He  had  six 
sons  and  two  grandsons  similarly  affected,  while  the 
females  of  the  family  escaped ;  the  two  grandsons 
mentioned  having  seven  sisters  who  were  free  from  the 
peculiarity. 

To  sum  up,  then,  direct  heredity  is  where  the  child 
takes  its  nature  or  constitution  from  its  parents ;  where 
no  prominent  character  in  the  child  is  not  to  be  found 
in  one  or  other  parent.  In  these  cases  there  is  almost 
invariably  a  preponderance  of  resemblance  to  one  or 
other  of  the  parents,  and  this  preponderance  may  run 
either  direct,  that  is,  in  the  same  sex  from  father 
to  son,  and  mother  to  daughter,  or  diagonally — from 
father  to  daughter,  and  from  mother  to  son.  Of  these, 
the  former — direct — is  decidedly  the  more  common  in 


72  MARRIAGE  AND  DISEASE. 

insanity,  epilepsy,  scrofula,  and  gout,  while  the  latter — 
diagonal — is  said  to  be  most  frequently  observed  in 
cases  of  structural  peculiarity. 

II.  KEVERSIONAL  HEREDITY  or  ATAVISM.  "This  is 
a  term  used  to  denote  cases  in  which  a  child,  instead 
of  resembling  its  immediate  parents,  resembles  one  of 
his  grandparents  or  still  remoter  ancestor,  or  even 
some  distant  member  of  a  collateral  branch  of  the 
family "  (Lucas).  This  is  a  very  common  form  of 
heredity.  To  recognise  some  peculiar  character  in  the 
grandchild  which  is  absent  in  the  parent,  yet  strongly 
marked  in  the  grandparent,  may  be  said  to  be  an 
almost  everyday  occurrence.  In  some  diseases — 
pathological  variations — this  mode  of  transmission  is 
so  regularly  followed  that  these  diseases  have  come 
to  be  looked  upon  as  only  attacking  every  other  gene- 
ration. Gout  thus  frequently  attacks  only  alternate 
generations,  and  there  are  several  other  diseases  which 
at  times  follow  the  same  rule ;  therefore  it  should  be 
understood  that  the  absence  of  a  "  family  disease  "  in 
one  generation  is  no  evidence  that  the  taint  has  been 
shaken  off  and  got  rid  of,  and  will  not  appear  in  the 
next  generation.  Sir  William  Aitken  states  his  opinion 
that  "a  family  history  extending  over  less  than  three 
generations  is  almost  worthless,  and  may  be  misleading." 

This  reversional  form  of  heredity  is  to  be  explained 
in  this  way  : — Where  the  peculiar  character  transmitted 
belongs  to  what  might  be  called  the  physiological  class, 
it  may  be  taken  that  its  reappearance  in  the  family  is 
the  result  of  the  action  of  the  natural  tendency  to 


THE  LA  WS  OF  HEREDITY.  73 

reversion  to  the  original  family  type;  and  where  the 
character  is  of  the  pathological  order,  as  in  insanity, 
gout,  idiocy,  and  the  like,  it  may  be  taken  that  the 
character,  or  tendency  thereto,  is  present  in  every 
generation,  but  in  some  remains  latent  all  through  life, 
either  because  it  has  been  too  far  mitigated  by  the 
infusion  of  the  untainted  blood  of  the  other  parent,  or 
because  it  has  not  received  some  necessary  fillip  to  act 
as  a  starting-point  or  exciting  cause. 

Of  this  latency  of  characters  we  have  many  examples. 
The  most  commonly  cited  is  gout,  but  there  is  a  much 
more  remarkable  instance  to  be  found  in  families  show- 
ing the  haemorrhagic  diathesis — commonly  known  as 
"  bleeders."  Here  the  peculiar  morbid  condition  is 
purely  hereditary,  and  although  it  has  been  rarely, 
if  ever,  seen  in  the  female,  it  is  regularly  transmitted 
through  the  females  to  the  males  of  the  next  gene- 
ration. It  may  even  be  transmitted  through  two  or 
three  generations  of  females,  to  reappear  in  the  males 
so  soon  as  that  sex  appears  in  the  family.  Dr.  Wick- 
ham  Legg  *  and  Dr.  Finlayson  •(•  have  studied  this  sub- 
ject, and  have  published  family  trees  illustrating  this 
strange  fact.  In  explanation  of  this  "  sexual  atavism," 
if  it  may  be  called  so,  of  the  haemorrhagic  diathesis,  I 
would  submit  that  the  morbid  condition  present  in 
these  cases  was  almost  from  the  first  necessarily  fatal 
to  the  females,  it  being  impossible  for  a  woman  of  this 
diathesis  to  pass  safely  through  parturition,  or  even 

*  St.  Bartholomew's  Hospital  Reports,  1881. 
t  Glasgow  Medical  Journal,  July  1882. 


74  MARRIAGE  AND  DISEASE. 

those  functions  which  must  precede  maternity.  For 
this  reason  only  the  offspring  of  those  females  in  whom 
the  character  was  latent  ever  came  into  being,  and  so 
in  time  this  came  to  be  the  type  of  the  degeneration, 
being  the  only  type  which  it  was  possible  to  propagate. 
Only  through  the  female  in  whom  the  character  was 
absent,  or  latent,  could  the  variety  be  continued. 

Atavism  or  Reversional  Heredity,  although  fre- 
quently met  with  in  the  transmission  of  physical 
peculiarities,  is,  perhaps,  more  often  met  with  where 
the  character  is  of  a  moral  or  mental  nature.  In  what 
is  known  as  moral  insanity  it  is  often  met  with,  while 
in  the  ordinary  intellectual  mental  disorders  it  is  very 
common,  the  offspring  of  him  or  her  who  is  of  neurotic 
family  and  who  has  actually  been  insane  frequently 
escaping  the  insane  temperament,  or  even  occasionally 
developing  high  talents,  approaching  genius  perhaps, 
while  in  the  next  generation  the  children,  instead  of 
inheriting  the  high  mental  characters  of  the  parent, 
revert  to  the  insane  type  once  more.  I  would  here 
remark  that  the  genius  springing  thus  at  intervals  from 
the  insane  stock  is  not  of  the  highest  description,  and 
notwithstanding  the  opinion  of  so  weighty  an  autho- 
rity as  Dr.  Maudsley,  who  fears  that  in  forbidding  the 
marriage  of  those  of  the  insane  temperament,  we  would 
to  a  certain  extent  be  stamping  out  genius  in  the 
race,  I  would  venture  to  express  the  opinion  that  the 
chances  of  the  insane  parent  enriching  the  world  by 
begetting  the  genius,  are  not  sufficiently  good  to  justify 
the  insane  in  hazarding  the  experiment. 


THE  LA  WS  OF  HEREDITY.  75 

III.  INDIRECT  OR  COLLATERAL  HEREDITY  is  said  to 
occur  when  a  child  resembles   mentally,   morally,   or 
physically,  some  relative  out  of  the  direct  line  of  its 
descent,  as  an  uncle  or  aunt.     This  is  in  reality  not 
a  distinct  form  or  mode  of  transmission,  but  only  a 
modification  of  the  atavism  we  had  under  the  last  head, 
and,  like  it,  is  to  be  explained  by  reversion.     That  is  to 
say,  the  parents  in  the  direct  line  are  variations  from 
the  original  family  stock,  while  the  collateral  descen- 
dants have  followed  it  more  nearly ;  and  the  children, 
in  displaying  the  characters  common  to  such  collateral 
relatives,  and  absent  in  their  parent,  are  merely  show- 
ing a  reversion  to  that  family  type  from  which  their 
parent  had  varied. 

IV.  INITIAL  HEREDITY.    This  depends  upon  the  tem- 
porary mood  or  condition,  good  or  evil,  fortunate  or 
unfortunate,  of  the  parents  when  they  become  such. 
This  form  of  heredity  is  not  given  by  Bibot,  but  its 
existence  is  perfectly  well  established,  and  it  has,  per- 
haps, more  influence  in  ordaining  what  the  child  shall 
be   than   any  other  heredity  except  the  direct  only. 
In  fact,  it  is  a  form  of  direct  heredity,  and,  save  that 
it  deals  only  with  temporary  conditions,  and  at  a  parti- 
cular time,  it  might  be  included  under  the  first  law. 

An  American  writer  says  : — "  A  good  initial  heredity 
may  produce  virtue  in  the  descendants  by  predis- 
position merely  from  a  temporarily  ennobled  nature 
although  there  was  a  general  vice  in  the  parents,  and 
so  a  bad  direct  heredity.  If  you  are  in  a  lofty  mood, 
Providence  is  on  your  side  ;  but  when  a  drunkard  on 


;6  MARRIAGE  AND  DISEASE. 

the  one  hand,  or  when,  on  the  other,  a  man  generally 
temperate,  but  in  a  temporary  debauch,  places  himself 
under  the  power  of  this  law  of  heredity,  the  specific 
or  initial  principle  acts  just  as  surely  to  produce  an 
inheritance  of  evil,  as  it  does  in  the  opposite  case  to 
produce  an  inheritance  of  good."  This  may  be  a  little 
too  poetically  expressed,  still  it  is  very  near  the  truth. 
Whether  a  temporary  elevated  or  ennobled  condition 
in  the  parent  can  override  a  fixed  family  viciousness 
we  are  not  in  a  position  to  assert  positively,  but  that 
a  temporary  depraved  condition  can  override  the  best 
family  predisposition  we  know  for  a  fact,  and  why 
this  law  should  not  act  for  good  as  well  as  for  evil  in 
the  race  we  fail  to  see.  As  regards  drunkenness,  Dr. 
Maudsley  says : — "  Here,  as  elsewhere  in  nature,  like 
produces  like;  and  the  parent  who  makes  himself  a 
temporary  lunatic  or  idiot  by  his  degrading  vice,  pro- 
pagates his  kind  in  procreation,  and  entails  on  his 
children  the  curse  of  the  most  hopeless  fate." 

That  drunkenness  and  other  vicious  temporary  con- 
ditions in  the  parent,  when  he  becomes  such,  have  a 
powerful  influence  for  evil  upon  the  child  begotten,  has 
long  been  known  amongst  the  people,  and  of  its  truth 
some  proofs  have  recently  been  collected.  Cases  are  by 
no  means  rare  in  which  a  temporarily  drunken  parent 
has  begotten  an  idiot  child.  Indeed,  several  observers 
have  collected  statistics  which  go  to  prove  that  the 
vast  majority  of  idiots  and  imbeciles,  who  are  not  the 
result  of  a  family  degeneration,  are  the  children  of 
drunken  and  otherwise  vicious  parents,  and  it  would 


THE  LA  WS  OF  HEREDITY.  77 

not  be  too  much  to  infer  that  much  of  the  mental  and 
moral  obliquity  and  degradation  met  with  in  the  poorer 
classes,  from  which  springs  the  instinctive  criminal, 
has  its  origin  in  vicious  initial  heredity.  Let  us  hope, 
then,  that  this  law  of  Nature  is  as  active  for  virtue  as 
for  vice,  and  take  it  that  not  a  little  of  that  which 
makes  human  nature  lovely,  is  the  outcome  of  a  pure 
and  ennobled  nature  in  the  parent  when  he  becomes 
such,  for  nothing  but  good  can  arise  from  the  teaching 
of  such  doctrine. 

Laurence  Sterne  shows  a  deep  insight  into  the  ways 
of  Nature  when,  in  the  opening  lines  of  "Tristram 
Shandy,"  he  says: — "I  wish  either  my  father  or  my 
mother,  or,  indeed,  both  of  them,  as  they  were  in  duty 
both  equally  bound  to  it,  had  minded  what  they  were 
about  when  they  begot  me ;  had  they  duly  considered 
how  much  depended  upon  what  they  were  then  doing, 
that  not  only  the  production  of  a  rational  being  was 
concerned  in  it,  but  that  possibly  the  happy  formation 
and  temperament  of  his  body,  perhaps  his  genius, 
and  the  very  cast  of  his  mind,  and,  for  aught  they 
knew  to  the  contrary,  even  the  fortunes  of  his  whole 
house  might  take  their  turn  from  the  humours  and 
dispositions  that  were  then  uppermost.  Had  they 
duly  weighed  and  considered  all  this,  and  proceeded 
accordingly,  I  am  verily  persuaded  I  should  have  made 
quite  a  different  figure,  on  the  whole,  from  that  in 
which  the  reader  is  likely  to  see  me.  Believe  me,  good 
folk,  this  is  not  so  inconsiderable  a  thing  as  many  of 
you  think  it." 


78  MARRIAGE  AND  DISEASE. 

V.  HEREDITY  OF  INFLUENCE.  This  is  seen  when  the 
child  of  a  second  marriage  resembles  the  husband  of 
a  previous  marriage;  as,  for  example,  when  a  white 
woman  has  had  children  by  a  first  husband  who  was  a 
negro,  and  afterwards  has  children  by  a  second  hus- 
band, who  is  of  white  blood,  and  the  children  by  this 
second  marriage  show  distinct  evidence  of  the  presence 
of  characters  peculiar  to  the  negro.  It  appears  that 
the  male  who  first  impregnates  a  female,  so  impresses 
the  organism  of  that  female  that  the  young  she  bears 
to  other  males  will  more  or  less  "  favour "  him  who 
first  impregnated  the  mother.  This  is  well  known  to 
the  breeders  of  animals,  who  are  most  careful  not  to 
permit  the  approach  of  chance  males,  as  the  influence 
of  such  a  cross  will  frequently  be  observable  in  many 
following,  pregnancies  by  other  males.  Nor  are  we 
without  evidence  of  the  working  of  this  law  in  the 
human  family  ;  but,  as  far  as  man  is  concerned,  it  is  of 
no  importance  except  to  the  medical  jurist,  whom  it 
sometimes  aids  in  deciding  paternity. 

These,  then,  may  be  taken  as  the  so-called  laws  of 
heredity,  which  have  been  formulated  to  include  most 
of  the  phenomena  met  with  in  families.  They  are  but 
arbitrary  divisions  of  the  one  great  law  or  principle, 
and  may  be  increased  in  number,  or  varied,  at  will. 
Some  writers  go  further  in  their  classification  of  heredi- 
tary phenomena,  and  make  a  large  number  of  divisions 
and  sub-divisions ;  but  this  serves  no  good  purpose,  and 
often  only  tends  to  confuse  the  student.  There  is, 
however,  one  class  of  cases  which,  while  not  deserving 


THE  LA  WS  OF  HEREDITY.  79 

inclusion  under  a  separate  head,  may  with  advantage 
be  here  briefly  considered.  This  is  what  has  been 
called — 

HEREDITY  AT  CORRESPONDING  AGES.  Here  the  pecu- 
liar character  may  have  been  transmitted  directly  from 
the  parents,  or  it  may  have  been  the  outcome  of 
reversion — in  fact,  it  matters  not  how  it  has  been 
acquired,  the  sole  peculiarity  to  be  noticed  being  the 
fact  that  the  character  makes  its  appearance  at  a 
certain  age,  and  that  age  is,  in  the  child,  the  same 
age  as  that  at  which  the  character  had  previously 
appeared  in  the  parent  or  other  ancestor.  This 
peculiarity  is  most  frequently  noticed  in  phthisical 
families,  but  it  often  occurs  in  cancer,  insanity,  and 
other  transmitted  degenerate  conditions.  It  is  a  matter 
of  common  observation  that  in  some  phthisical  families 
the  children  grow  up  strong  and  apparently  healthy, 
but  on  attaining  a  certain  age  the  inherited  disease, 
or  perhaps  I  should  say  the  disease,  a  predisposition 
to  which  has  been  inherited,  lights  up,  and- one  after 
another  they  die  off.  Austin  Flint,  in  his  excellent 
"  Practice  of  Medicine,"  when  speaking  on  this  point, 
says  : — "  This  congenital  predisposition  may  remain 
completely  latent  until  the  period  of  life  in  which 
the  disease  is  most  apt  to  be  developed;  and  we 
sometimes  see  a  whole  family  of  children,  one  after 
the  other,  fall  victims  to  this  disease  [phthisis],  when 
they  severally  reach  a  certain  age."  Of  course  our 
recently  acquired  knowledge  of  the  character  of  this 
disease  will  modify  largely  the  views  once  held  as  to 


8o  MARRIAGE  AND  DISEASE. 

the  hereditary  transmission  of  phthisis,  but  for  the 
present  we  shall  not  comment  on  the  above. 

In  insanity  this  "heredity  at  corresponding  ages" 
is  frequently  met  with,  a.s  it  is  also  in  cancer,  gout, 
and  rheumatism.  A  case  in  point  comes  to  my  mind. 
It  is  this : — A  father  (of  whom  I  could  get  but  little 
information)  was  addicted  to  drink,  and  became  insane 
at  about  forty  years  of  age.  He  had  four  sons.  The 
eldest  became  insane  at  the  age  of  forty -one,  the 
second  at  the  same  age  also  became  insane,  while 
the  third  and  fourth  sons  were  in  turn  certified  in- 
sane on  reaching  the  age  of  thirty-eight.  They  were 
all,  like  the  father,  given  to  habits  of  intemperance, 
and  not  one  of  them  ever  showed  any  sign  of  mental 
improvement  after  the  first  mental  failure.  Each 
sank  from  bad  to  worse,  and  soon  arrived  at  hopeless 
dementia.  The  eldest  of  these  brothers  is  at  present 
a  murderer  in  Broadmoor  criminal  asylum,  and  the 
otber  three  are,  as  I  have  said,  hopeless  dements  in  a 
county  asylum. 

And  now,  having  considered  the  courses  generally 
followed  by  Nature  in  the  transmission  of  hereditary 
characters,  we  will  glance  at  a  few  of  the  more  grave 
pathological  characters  commonly  transmitted,  and 
consider  what  advice  should  be  offered  persons  beariug 
such  taint  when  the  question  of  marriage  arises. 


CHAPTEE  VII. 

HEREDITY   IN   INSANITY. 

"  Legislative  enactments  regarding  the  inter- marriage  of  persons 
tainted  by  disordered  intellect  are  greatly  to  be  desired ;  and  the 
concealment  of  such  disorder,  with  a  view  to  marriage,  ought  to 
render  marriages  null  and  void  which  are  concluded  under  such 
circumstances." — SIR  WILLIAM  AITKEX.* 

INSANITY  has  been  at  all  times  in  the  world's  history 
the  most  dreaded  of  infirmities,  and  rightly  so,  for  no 
other  diseased  condition  whatever  inflicts  so  grievous 
suffering,  not  only  upon  its  victims,  but  upon  all  those 
nearest  and  dearest  to  them.  We  look  upon  the 
disease  as  cruel  which  tears  the  innocent  child  from  its 
mother's  breast ;  which  chills  the  warm  blood  and  for 
ever  stops  the  bounding  heart  of  youth,  or  lays  the 
young  father  or  mother  cold  in  death  before  the  eyes 
of  the  terror-stricken  children;  such  disease  we  look 
upon  as  cruel,  and  with  eyes  blinded  by  tears  for  those 
we  loved,  it  is  sometimes  very  difficult  for  us  to  see  in 
all  this  the  hand  of  a  kind  and  merciful  Providence. 
But  if  we  contrast  the  brief  suffering  of  the  dear  ones 
we  have  lost  with  the  lifelong  agonies  of  many  of  the 
insane,  we  must  rejoice,  and  say,  in  truth,  that  death 

*  "  The  Science  and  Practice  of  Medicine,"  p.  490,  vol.  ii. 


82  MARRIAGE  AND  DISEASE. 

has  been  "  cruel  only  to  be  kind,"  for  rather  a  thou- 
sand times  the  quiet  forgetfulness  of  the  tomb  than 
the  lifelong  battle  of  the  chronic  maniac,  the  imagi- 
nary, but  no  less  torturing  hell  in  which  the  melan- 
choliac  exists,  or  the  living  death  of  the  dement. 

And  if  it  be  certain  that  no  other  disease  causes 
such  terrible  suffering  and  degradation  in  its  victims, 
it  is  still  more  certain  that  there  is  no  "  ill  that  flesh 
is  heir  to "  which  creates  a  tithe  of  the  misery  and 
distress  amongst  the  relatives  and  dependents  of  those 
afflicted.  Need  I  speak  of  the  agonies  of  the  young 
wife,  but  yesterday  full  of  life  and  hope,  whose  partner 
has  been  dragged  shrieking  from  her  side,  leaving  her 
wedded  yet  widowed,  she  and  her  young  children  a 
charge  upon  the  cold  world,  or  perhaps  colder  friends  ; 
or,  on  the  other  hand,  the  terrible  position  of  the 
husband  who  has  learnt  to  look  with  terror  upon  the 
approach  of  what  should  be  a  time  of  family  rejoicing, 
and  who  must  curse  the  day  he  became  a  father,  when 
he  thinks  of  the  future  of  his  children.  Well  might 
the  ancients  imagine  such  things  could  but  come  from 
the  devil. 

According  to  the  last  report  of  the  Commissioners  in 
Lunacy  (June  1891)  there  were  no  less  than  86,795 
"lunatics,  idiots,  and  persons  of  unsound  mind"  in 
England  and  Wales.  It  must  be  remembered,  too, 
that  these  figures,  while  representing  the  great  mass  of 
our  insane  population,  by  no  means  exhaust  it,  for  there 
are  hundreds  of  senile  dements  and  idiotic  and  imbecile 
children,  epileptic  and  otherwise,  who,  belonging  to  the 


HEREDITY  IN  INSANITY.  83 

middle  classes,  are  kept  at  tome  among  their  relatives 
and  friends,  and  so  never  come  within  the  knowledge 
of  the  Board  at  Whitehall.  However,  taking  the 
Commissioners'  figures  alone,  we  may  say  that  there 
is  one  insane  person  to  every  300  of  the  population, 
which  is  a  statement  sufficiently  startling  in  itself. 

There  is  a  belief  abroad  that  insanity  is  on  the 
increase  among  the  people  of  these  countries,  and  cer- 
tainly the  figures  set  forth  year  after  year  by  the 
Commissioners  in  Lunacy  go  far  in  support  of  such 
belief.  If  we  take  the  totals  at  decennial  periods  we 
find  the  insane  population  of  England  and  Wales 
increased  alarmingly,  thus : — 

Total  insane  on  January  1 8;  9  .        .        .  36,762 

„  „  1869  ...  53,177 

„  „  1879  ...  69,885 

„  „  1889  ...  84,340 

Here  we  have  a  steady  increase  in  the  insane  popu- 
lation of  England  and  Wales  at  a  rate  of  over  1500 
a  year.  Nor  is  this  increase  to  be  accounted  for  by 
increase  in  the  general  population,  for  the  Com- 
missioners' own  figures  show  that  the  proportion  of 
insane  to  every  io,OOO  of  the  population  was  on 

January  1859  .  .  .  18.67  to  the  10,000 

1869  .  .  .  23.93           » 

1879  .  .  .  27.55           » 

»        1889  .  .  .  29.07           „ 

Many  men  learned  in  lunacy  and  well  able  to 
form  sound  opinions  on  the  subject,  have  reluctantly 
admitted,  that  upon  other  grounds  than  an  increased 


84  MARRIAGE  AND  DISEASE. 

liability  to  insanity  amongst  the  people  it  is  impossible 
satisfactorily  to  account  for  this  alarming  and  steady 
increase  in  our  insane ;  while  some  others,  equally 
familiar  with  the  subject,  have  endeavoured  with 
praiseworthy  zeal  to  prove  that  this  increase  in  the 
numbers  of  certified  lunatics  in  proportion  to  the 
population  is  entirely  due  to  the  fact  that  persons 
suffering  from  mild  forms  of  mental  derangement, 
such  as  would  have  passed  almost  unnoticed  a  few 
years  back,  are  now  admitted  to  asylums  there  to  be 
taken  care  of ;  and  further,  that  the  inmates  of  our 
asylums  are  now-a-days  so  well  cared  for  that  their 
lives  are  considerably  prolonged  and  they  go  to  swell 
the  numbers  of  the  registered  insane  years  after  they 
would,  under  the  older  modes  of  treatment,  have  passed 
over  to  the  majority. 

In  this  way  do  some  writers  endeavour  to  account  for 
the  terrible  accumulation  of  lunatics  which  has  been 
going  on  for  the  past  quarter  of  a  century  or  more ;  and 
certainly  the  fact  that  most  of  the  village  fools  and 
eccentric  wanderers  so  common  in  the  last  generation 
have  disappeared  from  their  usual  haunts,  is  proof  that 
in  some  degree  the  great  increase  in  the  population  of 
our  asylums  is  in  this  way  to  be  explained.  But  that 
it  can  be  wholly  put  down  to  this  ingathering  and 
preservation  of  the  "  weak  ones"  has  by  no  means  been 
satisfactorily  proven,  and  I  must  admit  that  I  go  with 
those  who  believe  mental  disease  to  be  on  the  increase 
in  these  countries. 

In  support  of  this  belief  I  would  point  out  that  if 


HEREDITY  IN  INSANITY.  85 

we  admit,  as  I  hold  we  must,  hereditary  taint  to  be  a 
predisposing  cause  of  insanity,  we  can  come  to  no  other 
conclusion.  There  is  no  class  of  diseases  so  surely 
transmitted  from  parent  to  child  as  the  nervous — upon 
this  point  the  whole  medical  profession  is  agreed ;  and 
that  our  present  laws  for  the  management  of  the  insane 
and  those  who  have  been  insane  tend  directly  to  spread 
insanity,  epilepsy,  and  allied  diseases  amongst  our 
people,  a  moment's  consideration  will  prove  conclu- 
sively. Take,  for  instance,  the  case  of  a  young  man 
who,  in  consequence  of  inherited  nervous  instability, 
becomes  insane.  He  is  treated  in  an  asylum,  and  as 
soon  as  he  recovers  from  the  acute  attack  he  is  dis- 
charged, however  bad  his  family  history  may  be. 
Being  naturally  impulsive  and  emotional,  and  having 
but  slight  control  over  his  passions,  he  not  infrequently 
marries  early,  perhaps  a  very  short  time  after  his  dis- 
charge from  the  asylum,  and  when  he  returns  to  the 
asylum — as  he  is  almost  certain  to  do — he  is  probably 
the  father  of  two  or  three  children.  Again  he  recovers, 
and  again  he  returns  home  to  beget  a  tainted  race. 
Ultimately,  in  all  probability,  this  man  returns  to  the 
asylum  to  remain  there,  but  before  that  stage  in  his 
downward  course  is  reached  he  has  possibly  left  a  large 
family  behind,  some  of  whom  will  most  likely  join  him 
in  the  asylum  before  he  dies.  No  large  asylum  is 
without  scores  of  such  cases  ;  they  make  up  a  large  part 
of  the  moving  population  of  such  institutions.  At 
present  one  case  comes  to  my  recollection.  It  is  that 
mentioned  in  the  last  chapter,  where  a  neurotic  father 


86  MARRIAGE  AND  DISEASE. 

had  four  sons,  each  of  whom  on  attaining  thirty-eight  to 
forty  years  of  age  became  insane.  These  four  men  must 
be  kept  for  the  remainder  of  their  lives  at  the  public 
expense.  But  that  is  not  the  worst.  Three  of  these  men 
married,  and  before  they  had  become  sufficiently  insane 
to  be  relegated  to  an  asylum  had  become  the  fathers  of 
thirty-four  children.  Nature  fought  against  this  pro- 
pagation of  the  unfit,  and  permitted  only  thirteen  of 
the  thirty-four  to  reach  maturity.  One  of  these  has 
since  dropped  dead  leaving  no  issue,  but  twelve  are 
still  left  as  a  legacy  to  the  coming  generation  of  rate- 
payers. Men  like  these,  or  those  others  who  also  form 
a  large  class,  who  beget  families  in  the  intervals  between 
attacks  of  mania,  melancholia,  or  epileptic  excitement, 
must  increase  the  insane  population,  and  the  system 
which  permits  such  propagation  must  not  be  surprised 
when  it  is  called  upon  to  build  new  asylums  or  add 
block  after  block  to  the  old. 

Or,  again,  take  the  case  of  a  woman  cursed  with  a 
bad  inheritance ;  she  marries,  becomes  pregnant,  and, 
unable  to  bear  the  strain  thus  thrown  upon  the  system, 
her  mind  gives  way  and  for  a  time  she  becomes  an 
inmate  of  some  asylum.  In  the  majority  of  cases  she 
too  recovers  for  a  time,  and  goes  out  into  the  world  to 
bring  forth  perhaps  a  large  family  loaded  with  a  double 
allowance  of  original  sin.  Every  asylum  medical  officer 
is  only  too  familiar  with  such  cases.  I  can  call  to  memory 
a  score  such  at  the  present  time,  women  who  return  to 
the  asylum  time  after  time,  each  visit  in  many  cases  fol- 
lowing or  preceding  the  birth  of  an  unfortunate  child. 


HEREDITY  IN  INSANITY.  87 

Now,  this  procedure  can  have  but  one  result,  and 
that  is,  the  cultivation  and  increase  of  insanity  and 
other  nervous  diseases  and  degenerations — as  epilepsy, 
chorea,  deaf-mutism,  suicide,  hysteria,  idiocy,  and  the 
like,  and  Sir  William  Aitken  is  certainly  justified  in 
asking  that  such  tainted  persons  should  not  be  per- 
mitted to  contaminate  the  race  by  propagating  their 
like. 

There  is  another  matter  which  requires  explanation 
before  we  can  admit  that  insanity  is  not  on  the  in- 
crease, and  that  is  suicide.  If  the  supposition  that 
the  increase  in  the  number  of  certified  insane  is 
entirely  due  to  the  gathering  together  of  nearly  all 
the  insane  in  the  asylums  be  true,  then  it  follows  that 
the  proportion  of  insane  outside  asylums  should  be 
proportionately  diminished,  and  consequently  suicide, 
which  we  may  take  in  the  majority  of  instances  to  be 
the  outcome  of  mental  disorder,  should  be  much  less 
frequent  than  it  was  before  the  insane  were  so  care- 
fully weeded  from  the  general  population.  If  the 
theory  of  those  who  say  that  insanity  is  not  on  the 
increase  be  sound,  deaths  from  suicide  amongst  those 
outside  asylums  should  diminish.  But  what  is  the  fact  ? 
On  reference  to  the  Registrar- General's  reports,  we  find 
that  deaths  from  suicide  are  increasing  year  by  year, 
much  as  the  certified  insane  are.  The  number  of 
deaths  from  suicide  recorded  in  1 864  was  1340;  in 
1870,  1554;  in  1875,  1601  ;  in  1880,  1979;  in  1885, 
2007;  and  in  1888  it  had  increased  to  2308.  Nor  is 
this  increase  apparent  only,  for  while  the  proportion 


88  MARRIAGE  AND  DISEASE. 

of  deaths  from  suicide  was  in  1864  only  64  to  the 
million,  it  had  risen  in  1888  to  8 1  to  the  million; 
which  is  an  increase  of  as  nearly  as  possible  33  per 
cent,  within  less  than  25  years.  How  those  who 
maintain  that  insanity  is  not  increasing  explain  these 
figures  of  the  Begistrar-General  I  do  not  know,  as  the 
matter  has  not  been  considered  in  this  connection,  so 
far  as  I  am  aware ;  but  I  fail  to  see  how  they  can 
reconcile  the  fact  that  suicide,  which  is  an  unmistak- 
able sign  of  what  we  know  as  the  insane  temperament, 
is  increasing  among  the  people,  with  their  assertion 
that  the  insane  have  been  winnowed  from  the  people 
to  an  extent  hitherto  unknown,  and  that  in  the  mean- 
time there  has  been  no  increase  of  insanity.  Until 
this  be  satisfactorily  explained,  I  must  decline  to 
believe  that  insanity  is  not  more  prevalent  now,  when 
suicides  rank  in  the  Registrar-General's  report  at  81 
to  the  million,  and  we  have  86,067  certified  lunatics 
in  asylums,  than  when  the  certified  insane  were  less 
than  half  and  the  suicides  33  per  cent,  under  what 
they  are  at  present. 

The  marriage  of  those  deeply  tainted  with  insanity 
or  predisposition  thereto  is  under  any  circumstances 
to  be  deplored,  but  what  makes  such  marriages  more 
terrible  is  the  fact  that  in  a  great  many  cases  the 
tainted  one  is  married  on  the  assumption  that  no  such 
bar  exists,  and  the  unfortunate  partner  only  discovers 
when  it  is  too  late  how  cruelly  he  or  she  has  been 
treated  by  the  one  above  all  others  implicitly  trusted. 
Concealment  of  such  family  blight  under  the  circum- 


HEREDITY  IN  INSANITY.  89 

stances  is  a  moral  wrong,  and  it  must  quickly  be  made 
a  legal  one.  The  Legislature  must  step  forward  and  say 
that  deception  of  this  kind,  deliberately  practised,  as 
it  too  frequently  is,  with  a  view  to  marriage,  shall  be 
sufficient  ground  for  a  nullification  of  the  marriage 
contract.  If  a  bill  were  at  present  brought  forward  so 
to  alter  the  law  it  would  receive  the  united  support 
of  the  scientific  and  legal  schools  of  thought. 

Unhappily,  however,  such  deception  is  not  always 
necessary ;  for,  strange  as  it  may  appear  to  some,  we 
know  it  to  be  a  fact  that  many,  well  knowing  the 
family  history  of  the  tainted  one,  disregard  it.  This 
disregard  arises  from  various  causes.  In  some  it  is 
the  outcome  of  ignorance,  and  here  from  education 
we  may  anticipate  good  results.  In  some  others  it 
arises  from  gross  carelessness,  which  is  nothing  short 
of  criminal.  But  in  the  great  majority  of  those  cases 
in  which  the  laws  of  Nature  are  disregarded,  and  more 
especially  amongst  the  educated  classes,  the  offenders 
are  guided  solely  by  sordid  and  selfish  motives,  such 
as  social  elevation  and  love  of  wealth.  In  all  civi- 
lised countries,  in  the  highest  families — not  excepting 
royalty  itself — we  find  men  and  women,  for  their 
own  personal  aggrandisement,  deliberately,  we  might 
almost  say  with  malice  aforethought,  entering  into 
marriages  which  can  only  end  in  disaster  to  the 
luckless  children.  Some  puling  sentimentalists,  who 
cannot  plead  ignorance,  assert  that  they  are  led  by 
love's  legendary  single  hair,  but  such  people  are  not 
to  be  believed.  A  bowstring  would  not  drag  a  vigorous 
7 


90  MARRIAGE  AND  DISEASE. 

and  right-minded  man  or  woman  to  such  a  fate.  These 
people  are  actuated  by  pure  selfishness,  as  is  another 
class,  the  quasi-religious,  who  throw  all  responsibility 
upon  Providence ;  canting  blockheads  who  forget  that 
God  helps  those  who  help  themselves,  and  who  refuse 
to  understand  that  Providence,  having  established  be- 
nign laws  for  the  government  of  His  creatures,  will 
not  stultify  Himself  by  staying  those  laws  in  answer 
to  the  whine  of  those  who  have  wittingly  disregarded 
and  violated  them.  In  all  these  cases,  high  and  low, 
selfishness  pure  and  simple  is  the  motive  power,  and 
the  strong  arm  of  the  law  should  be  invoked  to  pre- 
vent, so  far  as  is  possible,  such  selfishness  saddling  the 
community  with  a  helpless,  worthless  offspring. 

Still,  in  the  great  majority  of  cases  among  the 
middle  classes  deception  is  practised.  Eightly  or 
wrongly,  people  look  upon  insanity  or  epilepsy  as  a 
stigma  upon  the  family,  and  use  every  endeavour  to 
preserve  its  existence  unknown  to  the  world.  The 
answer  to  the  question,  "  Is  there  any  insanity  in  your 
family  ?  "  even  from  those  whose  word  upon  any  other 
question  might  be  implicitly  relied  on,  is  often  not 
worth  the  breath  which  gives  it  utterance.  Only  the 
other  day  I  asked  a  lady,  whose  daughter  was  insane, 
whether  any  other  member  of  the  family  had  ever 
suffered  from  any  mental  or  nervous  disease  of  any 
kind,  and  she  hastened  to  assure  me  that  such  a  thing 
was  unknown  to  the  family.  Having  had  a  different 
family-history  from  the  insane  daughter's  unfortunate 
husband,  I  was  rather  taken  aback  at  the  reply,  but 


HEREDITY  IN  INSANITY.  91 

guessing  upon  which  side  the  error  lay,  I  ventured 
the  further  question,  "  Did  not  another  daughter  of 
yours  commit  suicide?"  To  which  the  lady  replied 
without  a  blush,  "  Oh  yes,  I  had  forgotten  that." 
On  this  point  Maudsley  says  : — "  The  more  exact  and 
scrupulous  the  researches  made,  the  more  distinctly 
is  displayed  the  influence  of  hereditary  taint  in  the 
production  of  insanity.  It  is  unfortunately  impossible 
to  get  exact  or  accurate  information  on  this  subject. 
So  strong  is  the  foolish  feeling  of  disgrace  attaching 
to  the  occurrence  of  insanity  in  a  family,  that  people 
not  apt  usually  to  say  what  is  not  true,  will  disclaim 
or  deny  most  earnestly  the  existence  of  any  hereditary 
taint,  when  all  the  time  the  indications  of  it  are 
most  positive ;  yes,  when  its  existence  is  well  known, 
and  they  must  know  that  it  is  well  known.  To  elicit 
an  acknowledgment  of  the  truth  in  some  of  these 
cases,  would  be  as  difficult  a  task  as  to  elicit  from  an 
erring  woman  a  confession  of  her  single  frailty." 

And  yet,  in  spite  of  this  hard  lying  on  the  part  of 
relatives,  alienists  have  been  able  to  trace  distinct 
hereditary  taint  in  a  large  proportion  of  the  cases 
coming  under  their  observation.  Moreau  put  his  per- 
centage as  high  as  90.  Burrows  said  85,  Hoist  69, 
Jassen  65,  Miche'a  50  to  75,  Thurnam  51,  Webster 
32,  Needhain  31,  Guislain  30,  Maudsley  28,  and 
Esquirol  25. 

These  figures  vary  widely.  They  vary  with  the 
amount  of  prevarication  and  untruth  practised  by  the 
relatives  of  the  insane,  and  it  is  to  be  feared  that 


92  MARRIAGE  AND  DISEASE. 

until  human  nature  becomes  something  different  from 
what  we  know  it  to-day,  or  until  families  are  compelled 
by  law  to  keep  some  kind  of  family  record,  little  more 
than  we  at  present  know  on  this  most  important  sub- 
ject will  be  learnt  from  statistics.  From  education, 
the  modern  cure  for  all  ills,  we  can  expect  nothing, 
for  we  find  that  in  the  upper  classes,  where  education 
should  be  most  advanced,  truth  upon  this  one  point 
at  least  is  less  plentiful  than  among  the  ignorant. 

The  Commissioners'  summary  of  the  whole  number 
of  persons  certified  as  insane  in  1887,  shows  that  in 
spite  of  error,  accidental  and  premeditated,  close  on  a 
fourth — 23  per  cent. — were  by  heredity  predisposed 
to  insanity,  while  of  the  total  admissions  for  the  ten 
years  1878  to  1887  inclusive,  in  20.5  per  cent,  in- 
herited taint  was  admitted. 

Now,  in  view  of  this  conclusive  evidence  of  the 
hereditary  transmissibility  of  so  terrible  a  disease,  a 
disease  whose  ravages  in  society  scientific  men  and 
economists  alike  deplore,  and  whose  increase  under 
the  existing  state  of  things  medical  science  is  unable 
to  stay,  |J  think  the  time  has  arrived  when  some- 
thing should  be  done  to  limit  its  propagation,  either 
by  teaching  the  people,  or,  as  a  last  resort,  calling  in 
the  aid  of  the  Legislature.  Ultimately,  I  fear,  this 
latter  course  must  be  adopted,  for  the  reason  that 
many  of  those  of  the  insane  temperament  are  so  ill- 
balanced,  emotional,  and  impulsive,  that  they  are  ab 
best  only  semi-responsible,  and  the  teachings  of  science, 
however  convincing  to  the  thoughtful,  can  never  have 


HEREDITY  IN  INSANITY.  93 

any  great  weight  with  them.  Besides,  they  are  backed 
up  in  their  resolves  by  their  relatives,  who  are  about 
the  worst  counsellors  they  could  have.  Every  one  who 
has  had  much  to  do  with  the  insane  and  their  rela- 
tives has  noticed  the  mental  peculiarities  so  often 
exhibited  by  the  latter.  Very  frequently  their  minds 
are  crippled  and  deformed.  They  are  obstinate,  pas- 
sionate, wilful  and  suspicious,  the  higher  intelligence 
being  often  replaced  by  a  deep  low  cunning,  while 
the  moral  side  of  their  nature  is  equally  poorly  de- 
veloped. Weak  themselves,  and  with  such  counsellors, 
what  can  we  expect  ? 

I  have  seen  a  man,  whose  mother  was  an  imbecile, 
whose  sister  was  an  idiot,  and  who  was  little  better 
himself,  come  to  visit  his  wife  and  wife's  sister — 
whose  mother  had  also  been  insane — who  were  con- 
fined as  lunatics  in  the  game  asylum  in  which  his 
idiot  sister  resided,  and  I  have  watched  this  creature, 
the  father  of  three  children !  laugh  gleefully  at  the 
antics  of  his  relatives  in  the  visiting-room.  There 
are  thousands  of  such  ill-developed  men  and  women 
in  the  country,  creatures  whom  we  cannot  hope  to 
guide  otherwise  than  by  force.  Education  is  all  very 
well  in  its  place,  and  it  must  have  a  most  beneficial 
effect  amongst  those  who  have  sufficient  mental  deve- 
lopment to  appreciate  the  evil  under  which  their 
families  labour,  and  who  have  sufficient  strength  of 
will  to  enable  them  to  choose  the  good  rather  than  the 
evil.  But  with  those  like  the  man  above  mentioned 
it  is  useless  to  plead,  and  only  coercion  will  keep 


94  MARRIAGE  AND  DISEASE. 

them  in  the  right  path.  They  attend  upon  the  calls 
of  their  instincts  and  passions  as  does  the  unreasoning 
beast,  and  not  even  an  angel  from  heaven  could  hope 
by  moral  suasion  to  induce  them  to  curb  a  single 
appetite  or  in  any  way  mortify  the  flesh. 

Of  course  the  old  cry  of  "interference  with  the 
freedom  of  the  subject "  will  rise  like  a  spectre  to  bar 
the  path  of  legislation;  but  this  ghost  has  been  laid 
before  and  will  be  again.  These  wretched  creatures, 
far  down  in  the  scale  of  degeneration,  with  just  suf- 
ficient intelligence  to  keep  them  from  outraging  the 
usages  of  society ;  who  continue  their  kind  so  long  as 
nature  permits,  to  the  detriment  of  the  race;  who 
create  nothing,  add  nothing  to  the  commonwealth, 
but  are,  instead,  a  charge  upon  the  community; — these 
have  no  more  right  to  claim  freedom  of  action  as  to 
procreation,  than  has  the  leper  to  mingle  with  the 
populace. 

All  men  and  women  who  have  been  insane  once  and 
have  a  bad  family  history,  those  who  have  been  twice 
insane,  even  if  the  family  history  be  good,  and  all  who 
are  confirmed  epileptics  or  drunkards,  should  be  pre- 
vented by  the  state  from  becoming  parents,  for  they 
have  no  greater  right  to  carry  suffering  and  contami- 
nation amongst  the  people,  and  throw  expense  upon 
the  state,  than  has  the  person  suffering  from  small- 
pox to  do  so  by  travelling  in  a  public  conveyance. 
As  with  the  victim  of  the  small-pox,  it  is  their  mis- 
fortune more  than  their  fault,  but  of  this  society  can 
take  no  notice.  The  unfortunate  few  must  always 


HEREDITY  IN  INSANITY.  95 

suffer  for  the  benefit  of  the  many.  It  is  the  duty  of 
the  state  to  see  that  such  unfortunates  are  tended 
and  cared  for,  and  that  their  lives  are  made,  so  far  as 
is  possible,  bright  and  cheerful.  But  that  they  should 
be  permitted  to  hand  down  their  disease  to  innocent 
children,  any  more  than  the  sick  one  should  give  his 
small-pox  to  his  neighbours,  is  unfair  to  society  and 
to  the  race. 


CHAPTER  VIII. 

MARRIAGE  AND  INSANITY. 

"  If  we  are  seriously  minded  to  check  the  increase  or  lessen  the 
production  of  insanity,  it  would  be  necessary  to  begin  further  back, 
and  to  lay  down  rules  to  prevent  the  propagation  of  a  disease  which 
is  one  of  the  most  hereditary  of  diseases." — MAUDSLEY.* 

THIS  is  a  subject  upon  which,  it  is  difficult  to  speak, 
knowing,  as  we  do,  that  every  word  spoken  must 
crush  the  fondest  hope  of  some  unfortunate  fellow- 
creature.  However,  a  duty  should  not  be  shirked 
simply  because  it  is  unpleasant.  Too  long  has  senti- 
ment been  allowed  to  rule  our  better  judgment  in 
this  matter,  with  what  result  we  see,  and  the  sooner 
we  break  new  ground  the  better.  Discussion  must 
cause  pain  to  many,  but  silence  on  the  subject  would 
be  even  more  cruel;  for,  as  it  has  been  in  the  past 
it  would  be  in  the  future,  the  cause  of  much  suffer- 
ing, sin,  and  death,  which  otherwise  might  never 
appear  on  the  face  of  the  earth. 

First,  then,  I  would  advise  that  every  person  who 

knows  the  family  to  which  he   belongs  to  have  the 

bar-sinister  of  insanity   upon   its   escutcheon,   before 

daring   to   put   himself,   or    herself,   in    the    way    of 

*  "  Responsibility  in  Mental  Disease,"  p.  275. 


MARRIAGE  AND  INSANITY.  97 

becoming  a  parent,  should  carefully  examine  the 
family  tree,  get  to  understand  exactly  his  own  posi- 
tion, then  lay  the  whole  case  candidly  and  honestly 
before  the  physician,  and  abide  by  his  decision. 

Further,  I  would  advise  that  all  persons  who  con- 
template matrimony,  all  to  whom  attentions  and 
overtures  are  being  made  with  a  view  to  marriage, 
should  look  upon  a  mutual  exchange  of  confidences 
upon  this  matter  of  hereditary  or  family  disease  as 
absolutely  essential,  and  that,  too,  at  an  early  period 
of  the  intimacy,  before  the  affections  have  become 
deeply  engaged.  Too  often  knowledge  of  the  existence 
of  the  family  skeleton,  when  given  at  all,  is  only  given 
when  matters  have  gone  so  far  that  only  those  of 
strong  will  find  it  possible  to  give  up  the  loved  one 
because  of  an  evil  so  distant  and  shadowy  as  this 
family  taint  appears  in  the  eyes  of  the  lover. 

In  the  majority  of  families  in  which  mental  disease 
is  transmitted,  it  appears  in  only  one,  two,,  or  three 
members  of  each  generation ;  but  those  who  do  not  be- 
come insane  often  bear  the  taint  as  surely  to  the  next 
generation  as  do  those  who  have  actually  been  insane. 
In  rare  cases,  insanity  or  some  allied  nervous  disease 
attacks  every  member  of  a  family,  but  before  this  state 
of  things  is  reached  the  family  is  very  deeply  saturated 
with  disease,  and  is  fast  approaching  extinction.  Cases 
are  on  record  in  which  as  many  as  eleven  members 
of  a  family  have  been  insane.  I  myself  have  met 
with  a  case  where,  in  a  family  of  nine  children,  six 
died  within  the  first  year  of  life,  every  one  torn  by 


98  MARRIAGE  AND  DISEASE. 

convulsions,  while  two  of  the  remaining  three  were 
"  weak  in  their  minds,"  and  the  third  was  a  jabbering 
idiot,  the  inmate  of  an  asylum.  Such  lamentable 
cases  are  generally  the  result  of  marriages  in  which 
both  parents  belong  to  the  neurotic  or  insane  type. 
The  deeper  the  taint  the  less  likely  are  the  children 
to  escape  it,  and  nothing  so  certainly  tends  to  deepen 
the  taint  as  "in  and  in"  breeding.  The  children  of 
a  person  come  of  an  insane  stock  will  be  infinitely 
more  likely  to  escape  the  family  blight  if  that  person 
marry  a  healthy  person,  than  if  he  marry  one  come 
of  a  family  like  his  own,  and  every  effort  should  be 
made  to  impress  upon  the  public  mind  the  danger  of 
inter-marriage  amongst  neurotic  families. 

The  person,  man  or  woman,  who  has  had  an  epileptic, 
or  choreic,  or  imbecile  brother  or  sister,  an  insane  uncle, 
aunt,  or  parent,  or  even  grandparent,  should  never  for 
a  moment  permit  himself  to  look  upon  a  member  of 
any  neurotic  family — that  is,  one  in  which  insanity, 
epilepsy,  habitual  drunkenness,  suicide,  or  imbecility 
has  at  any  time  appeared — as  a  probable,  or  even 
possible,  partner  in  marriage ;  for  although  the  disease 
has  appeared  in  but  one  or  two  members  of  the  family 
it  shows  that  the  tendency  is  there,  and  the  chances  of 
the  children  not  inheriting  disease  from  such  a  union 
will  be  very  slight.  Those  of  neurotic  family  should 
never  forget  that  the  safety  of  their  children  wholly 
depends  upon  their  choice  of  partners.  If  they  marry 
one  not  of  their  own  type  the  tendency  to  nervous 
disease — if  not  too  deeply  marked  in  themselves — may 


MARRIAGE  AND  INSANITY.  99 

be  totally  lost  in  the  children  from  the  action  of  the 
vis  medicatrix  naturae,;  whereas  if  they  marry  into  a 
family  like  their  own,  there  will  be  little  chance  of 
reversion  to  the  healthy  type,  most  likely  the  peculiar 
conformation  or  temperament  which  predisposes  to 
insanity  will  be  accentuated  in  the  children,  and  pro- 
bably idiocy,  imbecility,  epilepsy,  chorea,  drunkenness, 
crime,  suicide,  or  insanity  will  make  its  appearance  in 
the  degenerate  offspring,  as  in  some  of  the  families 
whose  histories  are  given  in  these  pages. 

All  these  diseases,  together  with  neuralgia,  hysteria, 
cancer,  and  the  li£e,  are  allied,  and,  following  some  law 
at  present  unknown  to  us,  replace  each  other  in 
successive  generations,  and  in  different  individuals  of 
the  same  generation  in  a  manner  at  present  inexplic- 
able (vide  p.  49).  Thus  the  son  of  an  insane  parent 
may  be  a  confirmed  drunkard,  and  he  in  turn  may 
beget  a  family  one  member  of  which  may  inherit  his 
father's  vice,  while  another  may  be  epileptic,  another 
idiotic,  and  yet  another  who,  perhaps  after  giving  early 
promise  of  superior  intellectual  attainment,  will  become 
insane.  But  although  these  allied  diseased  conditions 
do  exchange  places  in  unaccountable  manner  in  neurotic 
families,  we  are  not  by  any  means  without  examples 
of  the  transmission  of  the  same  form  of  mental  disease 
through  several  generations,  or  even  of  the  same  mental 
disease  appearing  at  almost  exactly  the  same  age  and 
under  like  circumstances. 

Esquirol  was  of  opinion  that  as  a  rule  the  same  form 
of  mental  disease  was  transmitted,  and  this  opinion  was 


ioo  MARRIAGE  AND  DISEASE. 

confirmed  by  Moreau,  who  says  : — "  It  is  rare  that  the 
form  the  malady  assumes  does  not  present  the  most 
striking  resemblance,  sometimes  even  a  true  identity." 
During  ten  years'  experience  amongst  the  insane  I  may 
say  I  have  met  with  the  same  form  of  mental  disorder 
repeated  in  different  members  of  the  same  family  suffi- 
ciently often  to  induce  me  to  agree  to  a  great  extent 
with  this  dictum  of  Moreau.  But  although  every  form 
of  insanity  tends  thus  to  be  transmitted  unchanged  in 
the  family,  all  forms  are  not  equally  stable,  some  being 
much  more  commonly  transmitted  unaltered  than  others. 
Of  all  forms  of  mental  disease  by  far  the  most  certainly 
transmitted  unaltered  is  the  propensity  to  suicide ;  the 
other  forms  in  order  of  frequency  following  thus — dip- 
somania, melancholia,  monomanias,  mania,  imbecility. 

Dr.  Stewart  of  the  Crichton  Institution,  after  a  study 
of  901  cases  of  mental  disease,  gave  the  proportion  of 
hereditary  cases  in  the  different  forms  of  insanity  thus : 
Melancholia,  57.7;  dipsomania,  63.4;  mania,  5  i.o ;  mono- 
mania, 49.0 ;  moral  insanity,  50.0 ;  general  paralysis, 
47.6  ;  and  idiocy  and  imbecility,  36.0  per  cent. 

A  striking  example  of  transmission  of  the  suicidal 
propensity  is  given  by  Dr.  Hammond  of  New  York,* 
the  case  being  the  more  remarkable  from  the  fact  that 
exactly  the  same  means  were  adopted  to  destroy  life 
and  at  about  the  same  age  in  each  of  the  three  genera- 
tions :  "  A  gentleman  well-to-do  in  the  world,  but 
with  a  slight  hereditary  tendency  to  insanity,  killed 
himself  in  the  thirty-fifth  year  of  his  age  by  cutting  his 
*  "  Insanity  and  its  Medical  Kelations." 


MARRIAGE  AND  INSANITY.  101 

throat  while  in  a  warm  bath.  No  cause  could  be 
assigned  for  the  act.  He  had  two  sons  and  a  daughter 
— all  under  age  at  the  time  of  his  death.  The  family 
separated,  the  daughter  marrying.  On  arriving  at  the 
age  of  thirty-five  the  eldest  son  cut  his  throat  while  in 
a  warm  bath,  but  was  rescued  ere  life  was  extinct. 
At  about  the  same  age  the  second  son  succeeded  in 
killing  himself  in  the  same  way.  The  daughter  in  .her 
thirty-fourth  year  was  found  dead  in  a  bath-tub  with 
her  throat  cut.  Her  son  at  the  age  of  twenty-seven 
attempted  to  kill  himself  by  cutting  his  throat  while 
in  a  bath  at  his  hotel  in  Paris,  but  did  not  succeed. 
Subsequently  at  the  age  of  thirty  he  made  a  similar 
unsuccessful  attempt,  but  was  again  saved.  A  year 
afterwards  he  was  found  in  his  bath  by  his  servant  with 
his  throat  cut  from  ear  to  ear." 

Voltaire  records  and  comments  upon  a  like  case  in 
these  words : — "I  have  almost  with  my  own  eyes  seen 
a  suicide  whose  case  deserves  the  attention  of  physi- 
cians. A  man  of  serious  turn  of  mind,  of  mature 
age,  and  of  irreproachable  conduct,  free  from  strong 
passions,  and  above  want,  killed  himself  on  the  I7th 
October  1769,  and  left  a  written  explanation  of  his 
act,  addressed  to  the  council  of  the  city  in  which  he 
was  born.  This  it  was  thought  best  not  to  publish,  for 
fear  of  encouraging  others  to  quit  a  life  of  which  so 
much  evil  is  spoken.  In  all  this  there  was  nothing 
astonishing — such  cases  are  met  with  every  day;  but 
the  sequel  is  more  remarkable.  His  father  and  his 
brother  had  each  committed  suicide  at  the  same  age  as 


102  MARRIAGE  AND  DISEASE. 

himself.  What  hidden  disposition  of  the  organs,  what 
sympathy,  what  combination  of  physical  laws  caused 
the  father  and  his  two  children  to  perish  by  their  own 
hands,  by  the  same  method,  and  at  the  same  age  ?  "  * 

Falret  gives  the  case  of  a  family  in  which  the  grand- 
mother, mother,  and  grandchildren  were  the  subjects 
of  suicidal  melancholia,  and  records  the  history  of 
another  family  thus: — The  father  was  of  a  taciturn 
disposition ;  he  had  six  children,  five  boys  and  a  girl. 
The  eldest,  aged  forty,  precipitated  himself  from  the 
third  storey,  without  any  motive ;  the  second  in  age 
strangled  himself  at  thirty-five ;  the  third  threw  him- 
self from  a  window  in  attempting  to  fly;  the  fourth 
shot  himself  with  a  pistol ;  and,  lastly,  a  cousin  jumped 
into  a  river  from  a  trifling  cause.f  Scores  of  such 
cases  might  be  quoted;  they  are  familiar  to  every 
asylum  physician.  But  I  need  not  load  these  pages 
with  such  melancholy  records,  enough  has  been  already 
given  to  make  clear  to  the  reader  with  what  fatal 
certainty  this  tendency  towards  self-destruction  is 
handed  down  from  parent  to  child.  There  is  one 
other  point,  however,  upon  which  I  would  like  to  say 
a  word,  and  that  is,  suicide  amongst  children.  Fifty 
years  ago  suicide  of  children  of  tender  years,  which 
has  of  late  become  so  painfully  common,  was  almost 
unknown.  Some  put  this  down  to  an  earlier  develop- 
ment of  the  mental  powers  in  consequence  of  forced 
education,  that  is  to  say,  the  period  of  reasoning 

*  "  Dictionnaire  Philosophique." 
t  Bucknill  Tuke's  "Psychological  Medicine." 


MARRIAGE  AND  INSANITY.  103 

discretion  is  arrived  at  at  a  much  earlier  age  than 
formerly.  To  this  I  have  two  objections — first,  that 
suicide  was  almost  unknown  amongst  the  children  of 
the  classes  of  fifty  years  ago,  although  they  were 
highly  educated,  and  frequently  at  an  early  age ;  and 
second,  that  this  argument  must  be  based  upon  the 
assumption  that  suicide  is  the  outcome  of  healthy 
reasoning,  which  I  think  few  will  admit.  Education, 
forced  at  too  early  an  age,  has  doubtless  something 
to  do  with  this  lamentable  increase  of  child  suicide, 
inasmuch  as  it  conduces  to  the  building  up  of  those 
disordered  nervous  conditions  from  which  is  evolved 
the  insane  temperament ;  or  it  may  act  as  an  exciting 
cause  in  an  ill-balanced  and  ill-developed  mind,  but 
beyond  this  it  is  seldom  responsible  for  these  child 
suicides.  The  real  cause  is  inherited  taint,  just  as  it 
is  in  the  adult.  Some  hereditary  defect  will  be  found 
in  all  sucH  cases,  if  a  sufficiently  careful  search  be 
made.  "  If  the  child's  family  history  be  inquired  into, 
it  will  usually  be  found  that  a  line  of  suicide,  or  of 
melancholic  depression  with  suicidal  tendency,  runs 
through  it.  So  it  comes  to  pass  that  a  slight  cause  of 
vexation  is  sufficient  to  strike  and  make  vibrate  the 
fundamental  life-sick  note  of  its  nature.  "  * 

The  next  most  regularly  transmitted  diseased  nervous 
condition  is  dipsomania.  This  we  will  consider  later, 
and  for  the  present  pass  on  to 

Melancholia. — This,  which  is  one  of  the  most  painful 
forms  which  mental  disease  can  assume,  has  long  been 
*  Maudsley  in  Fortnightly  Review,  May  1886. 


OF 


THE 


p 


UNIVERSITY 


104  MARRIAGE  AND  DISEASE. 

noted  for  the  persistency  with  which  it  clings  to  a 
family,  often  appearing  at  about  the  same  age  genera- 
tion after  generation,  and  even  the  same  delusions — as 
of  ultimate  condemnation,  impending  poverty,  and  the 
like — appearing  again  and  again.  When  a  person 
falls  into  melancholia  it  is  usually  set  down  to  ill- 
health,  or  to  over-work,  to  real  business  trouble  or 
domestic  affliction.  Doubtless  in  some  few  cases  this^ 
may  be  true,  but  in  all  cases  hereditary  taint  should 
be  suspected  and  searched  for,  for  no  form  of  insanity 
is  so  frequently  attributable  to  this  cause,  except 
only  the  tendency  to  suicide,  and  the  drink-crave.  As 
Esquirol  says : — "  Melancholiacs  are  born  with  a  pecu- 
liar temperament,  which  disposes  them  to  melancholy." 
This  regularly  transmitted  melancholia  which  appears 
in  youth  and  middle  life  may,  or  may  not,  be  accom- 
panied by  a  tendency  to  suicide.  In  some  melancholiacs 
the  impulse  to  self-destruction  is  ever  present,  in 
others  it  only  appears  with  periodic  exacerbations 
of  depression,  while  in  another  and  still  more  painful 
class  the  unholy  fear  of  horrors  to  be  experienced 
in  the  next  world  makes  the  sufferer  cling  to  his 
wretched  life  with  the  tenacity  of  despair.  Doubtless 
many  of  those  cases  in  which  suicide  appears  in 
succeeding  generations  might  be  pub  down  to  inherited 
melancholia  with  suicidal  tendency,  for  it  is  almost 
impossible  to  distinguish  those  cases  in  which  mental 
depression  and  weariness  of  life  precede  and  lead  up 
to  the  act  of  self-destruction  from  those  in  which 
the  blind  impulse  to  leave  the  world  exists  alone. 


MARRIAGE  AND  INSANITY.  105 

• 

Often  the  imaginary  troubles  of  the  melancholiac  are 
long  borne  in  silence.  Frequently  the  sufferer  lets 
his  unreal  woes  "  like  a  worm  i'  the  bud "  eat  at 
his  vitals  unknown  to  the  world,  and,  if  not  betrayed 
by  his  worn  and  gloomy  exterior,  having  lost  hope 
of  relief  in  this  world,  seeks  it  in  the  next,  taking 
his  secret  with  him. 

A  good  example  of  the  wonderful  influence  of  in- 
herited taint  is  seen  in  those  painful  cases  of  melan- 
cholia which  we  so  frequently  meet  with  among  those 
of  atheromatous  habit  who  have  passed  the  meridian 
of  life.  In  these  cases,  when  the  vessels  become  so 
loaded  with  earthy  matter  as  to  be  impervious  to  the 
blood,  the  surrounding  tissue  undergoes  the  usual 
degenerative  changes  consequent  on  starvation.  Now, 
if  the  patient  be  of  stable  nervous  temperament,  he 
will,  as  the  nervous  degeneration  proceeds,  sink  quietly 
through  his  second  childishness  into  the  oblivion  of 
dotage;  but  if,  on  the  other  hand,  he  has  inherited 
the  insane  diathesis,  delusions  of  persecution,  of  im- 
pending poverty,  or  of  eternal  condemnation  will  arise 
to  make  miserable  the  evening  of  his  life. 

These,  then — suicide,  dipsomania,  and  melancholia 
— are  the  forms  of  mental  disease  which  are  most 
frequently  transmitted  unaltered  along  the  family  line, 
but  the  others  (as  mania,  monomania,  moral  insanity, 
propensity  to  crime  and  idiocy)  may,  and  sometimes 
do,  appear  again  and  again  in  families.  Lucas  quotes 
Haller,  who  gives  the  case  of  "two  noble  families  in 
which  idiocy  had  appeared  for  nearly  a  century  when 


106  MARRIAGE  AND  DISEASE. 

he   wrote,   and    in    which   it   still   appeared   in   some 
members  of  the  fourth  and  fifth  generations." 

It  may  be  said  at  once  that  no  family  is  safe,  any 
member  of  which  has  suffered  any  form  of  mental 
disorder,  from  whatever  cause.  Of  course  there  are 
cases  where  mental  disorder  follows  prolonged  in- 
temperate habits,  injuries  to  the  head,  sunstroke  and 
the  like,  but  even  here  the  mental  disturbance  generally 
points  to  a  peculiar  temperament  which  predisposes 
to  mental  disease,  and  in  a  great  many  of  these  cases 
careful  search  will  discover  in  near  relatives  insanity, 
or  peculiarities  approaching  thereto.  It  is  not  every 
one  who  has  suffered  from  sunstroke  or  has  had  a 
blow  on  the  head  that  goes  insane,  and  when  we  find 
upon  inquiry  that  the  majority  of  those  who  do,  belong 
to  neurotic  families  and  have  insane  relatives,  while 
the  majority  of  those  who  do  not  are  members  of 
untainted  families,  there  is  but  one  conclusion  to  be 
drawn,  viz.,  that  even  in  what  may  be  called  traumatic 
insanity,  hereditary  predisposition  cannot  be  ignored. 
Besides,  it  must  be  remembered  that  acquired  diseased 
conditions  of  this  kind  tend  to  be  transmitted  to 
children  afterwards  begotten,  as  was  the  epilepsy 
artificially  produced  by  Brown-Sequard  in  guinea-pigs 
transmitted  to  their  young.  Hence  the  man  or  woman 
who  has  been  insane,  be  the  cause  what  it  may,  can 
never  be  justified  in  becoming  a  parent.  Even  those 
in  whose  families  general  paralysis  has  occurred, 
should  be  most  careful  not  to  marry  into  a  neurotic 
family,  for  this  most  hopeless  disease,  which  was  long 


MARRIAGE  AND  INSANITY.  107 

looked  upon  as  the  result  of  fast  living  and  dissipation 
in  the  healthy — indeed,  in  some  of  the  most  finely 
developed  men — is,  upon  inquiry,  turning  out  to  be  to 
a  large  extent  confined  to  families  where  other  mental 
and  nervous  diseases  are  common.  In  fifty-six  cases 
of  general  paralysis  in  males,  of  which  I  have  taken 
notes,  I  found  a  family  history  of  insanity  in  no  less 
than  eleven,  or  19.6  per  cent.,  notwithstanding  that 
in  ten  of  the  cases  I  could  get  no  history  whatever. 
The  father  had  been  insane  in  two  cases,  the  mother 
in  one,  one  or  more  sisters  in  four,  a  sister  imbecile 
in  one,  and  in  three  other  cases  near  relatives  in  the 
direct  line  had  been  insane.  Had  I  been  able  to 
inquire  into  all  of  the  fifty-six  cases,  I  have  no  doubt 
that  the  percentage  showing  hereditary  taint  would 
have  been  markedly  higher. 

In  estimating  the  importance  or  gravity  of  the 
hereditary  taint  in  any  given  case,  several  points  are 
to  be  considered,  as — whether  the  insanity  h,as  "  run 
in  the  family "  for  some  generations,  or  has  appeared 
recently ;  whether  the  parent  had  been  actually  insane 
before  he  became  a  parent;  whether  one  or  both 
parents  were  tainted;  the  number  of  relatives  in  the 
direct  line  who  have  shown  the  neurotic  temperament, 
and  whether  the  disease  attacks  one  sex  only,  as  is 
sometimes  the  case,  or  appears  equally  frequently  in 
both.  From  what  has  been  said  in  the  preceding 
pages,  it  should  be  clear,  that  the  insanity  of  one 
parent  would  indicate  a  less  degree  of  predisposition 
than  that  of  a  parent  and  a  grandparent,  for  with  each 


io8  MARRIAGE  AND  DISEASE. 

transmission  the  character  gains  prepotency ;  becomes 
more  ingrained  in  the  family  nature,  and  so  stands  a 
better  chance  of  being  transmitted  again.  Insanity 
in  uncles  or  aunts  in  the  same  line,  added  on  to  the 
disease  in  parent  and  grandparent,  of  course  increases 
very  greatly  the  gravity  of  the  case ;  showing,  as  it  does, 
the  firm  hold  the  disease  has  got  upon  the  family. 

A  predisposition  to  insanity  in  both  parents,  even 
when  it  is  not  very  deeply  marked,  is,  as  we  have  seen, 
always  most  serious.  In  such  cases  there  is  little  or 
no  chance  of  reversion  to  the  healthy  type.  The 
children  very  frequently  take  on  some  of  the  more 
marked  forms  of  nervous  degeneracy,  as  idiocy  or 
imbecility,  with  epilepsy  or  some  physical  deformity 
added  on,  as  paralysis,  club-foot,  squint,  blindness, 
deaf-mutism,  &c.  Even  when  neither  imbecile  nor 
deformed  such  children  are  very  often  sterile,  and  the 
family  rapidly  becomes  extinct. 

Here  is  the  family  tree  of  a  patient  of  my  own,  which 
shows  the  terrible  effect  of  a  double  parental  taint  upon 
the  children : — 

K  S.'s  FAMILY. 


Epileptic. 

Had  insane 
sister. 

1 

Epileptic. 
Dead. 
No  issue. 

~T 

Epileptic  and 
insane. 
Dead. 
No  issue. 

i         A 

Idiot            Sane  as 
Impotent.          yet. 

i 

Insane. 
Suicidal  melancholiac. 
Incurable. 
No  issue. 

Has  family  of 
nine.     Some 
are  imbecile. 

MARRIAGE  AND  INSANITY.  109 

Here  the  epilepsy  of  the  father,  combining  with  the 
insane  taint  in  the  mother,  came  very  nearly  exter- 
minating the  family  in  one  generation.  Only  one  of 
the  five  wretched  children  leaves  issue,  and  in  all 
likelihood  her  miserable  offspring  are  the  last  repre- 
sentatives of  a  decaying  stock. 

Many  examples  of  the  dire  effect  of  the  inter- 
marriage of  the  neurotic  or  insane  diathesis  might  be 
cited.  I  will,  however,  content  myself  with  giving 
the  following,  which  I  take  from  Doutrebente's  "  An- 
nales  Medico- Psychologiques"  1869. 

First  Generation.  Father  intelligent,  became  melan- 
cholic and  died  insane.  Mother  nervous  and  emotional. 

Second  Generation.  Ten  children.  Three  die  in 
childhood.  Seven  reach  maturity  as  follows  : — Daughter 
A.  a  melancholiac ;  daughter  B.  insane  at  twenty; 
daughter  C.  imbecile;  daughter  D.  a  suicide;  son  E. 
imbecile ;  son  F.  a  melancholiac ;  son  G.  a  melan- 
choliac. 

Third  Generation.  A.  has  ten  children ;  five  die 
in  childhood,  one  is  deformed,  one  has  fits  of  insanity, 
one  is  eccentric  and  extravagant,  two  are  intelligent 
and  marry,  but  are  childless.  B.  leaves  no  issue.  C. 
has  one  child,  a  deformed  imbecile.  D.  has  three 
children ;  one  is  an  imbecile,  one  dies  of  apoplexy  at 
twenty-three,  and  the  third  is  an  artist,  described  as 
"  extravagant."  E.  has  two  children ;  one  dies  insane, 
the  other  disappears,  and  is  supposed  to  have  com- 
mitted suicide.  F.  is  childless.  G.  has  one  child,  who 
is  imbecile. 


i io  MARRIAGE  AND  DISEASE. 

In  this  family,  as  in  that  mentioned  above,  the 
presence  of  the  neurotic  taint  in  both  parents  rendered 
a  reversion  to  the  healthy  type  impossible,  and  Nature, 
refusing  to  continue  a  family  so  degenerate,  stamped 
it  out  in  the  third  generation. 

Now,  what  would  the  world  have  lost  that  it  could 
not  well  have  spared,  had  the  ancestors  of  these 
wretched  families  been  forbidden  the  right  of  procrea- 
tion ?  Nothing.  It  would  have  escaped  an  inestim- 
able amount  of  suffering,  past,  present,  and  to  come: 
a  considerable  amount  of  pauperism  and  consequent 
tax-gathering — that  is  all. 

When  the  insane  diathesis  is  present  in  only  one 
parent,  even  though  it  be  deeply  marked,  it  is  gene- 
rally possible  by  wise  marriages  to  lessen,  and  even 
perhaps  in  time  completely  to  eradicate  it.  But 
when  both  parents  are  of  the  insane  temperament  the 
pathological  character  is  so  aggravated  and  deepened 
in  the  offspring,  that  they  are  never  able  to  shake  it 
off.  Many  of  the  children  of  such  unions,  as  we  have 
seen  above,  die  in  childhood.  A  great  number  of  the 
remainder  are  sterile  and  deformed,  and  of  those  who 
come  to  maturity,  and  are  fruitful,  few  indeed  live  in 
a  second  generation.  The  stock  which  springs  from 
parents  both  of  the  insane  type,  almost  invariably 
dies  out  in  the  second,  or,  at  latest,  third  generation. 

Again,  the  influence  of  the  insanity  of  a  parent  in 
creating  a  predisposition  in  the  offspring,  will  much 
depend  upon  the  time  at  which  the  mental  disorder 
has  appeared,  for  while  in  every  case  its  presence 


MARRIAGE  AND  INSANITY.  in 

shows  a  certain  tendency  to  nervous  disease  or  de- 
generation, yet  if  it  did  not  appear  in  the  parent 
until  after  the  offspring  was  begotten,  its  effect  will 
not  be  nearly  so  grave  in  the  children  as  if  the  parent 
had  been  actually  insane  before  he  became  such. 
Every  attack  of  insanity,  however  brief  its  course, 
increases  the  liability  to  subsequent  attacks  in  the 
individual,  and  also  very  greatly  magnifies  the  danger 
to  the  offspring  afterwards  born. 

M.  Baillarger.  after  careful  research  and  the  study 
of  a  great  number  of  cases,  arrived  at  the  following 
conclusions,  which  have  since  been  verified  by  several 
observers  and  are  accepted  by  most  authorities. 

"  I.  The  insanity  of  the  mother,  as  regards  trans- 
mission, is  more  serious  than  that  of  the  father;  not 
only  because  the  mother's  disorder  is  more  frequently 
hereditary,  but  also  because  she  transmits  it  to  a 
greater  number  of  children. 

"  2.  The  transmission  of  the  mother's  insanity  is  more 
to  be  feared  with  respect  to  the  girls  than  the  boys ; 
that  of  the  father,  on  the  contrary,  is  more  dangerous 
as  regards  the  boys  than  the  girls. 

"  3.  The  transmission  of  the  mother's  insanity  is 
scarcely  more  to  be  feared,  as  regards  the  boys,  than 
that  of  the  father ;  the  mother's  insanity,  on  the  con- 
trary, is  twice  as  dangerous  to  the  daughters." 

And  now  the  question  arises — which  of  these  should 
marry  ?  Who  shall  take  the  place  of  the  censor  and 
say,  this  one  and  this  shall,  and  these  others  shall  not  ? 
In  this  very  grave  position  the  alienist  physician  often 


112  MARRIAGE  AND  DISEASE. 

finds  himself,  but  his  load  of  responsibility  is  generally 
lightened  by  the  knowledge  that  his  dictum  is  not 
final ;  that  most  of  his  clients  have  appealed  to  him  in 
the  hope  that  his  verdict  may  be  favourable,  and  with 
a  determination  already  formed  to  act  upon  it  if  it  be 
so,  and  to  disregard  it  and  risk  the  consequences  if  it 
prove  the  reverse.  Too  often  he  is  told  but  half  the 
truth — the  applicant  in  too  many  cases  is  pleased  to 
deceive  himself  and  his  adviser ;  and  having  so  gained 
a  favourable  decision  by  fraud,  deliberately  enters  on  a 
course  he  knows  to  be  studded  with  dangers ;  to  live 
in  a  fool's  paradise  until  the  day  of  reckoning  comes. 
In  some  cases  it  comes  very  soon,  as  where  the  first- 
born's vacant  face  is  scanned  day  after  day,  and  the 
heart  sinks  as  the  terrible  fact  forces  itself  upon  the 
parent  that  his  child  is  an  idiot ;  or  where  the  young 
wife  suddenly  loses  all  that  made  her  godlike,  all  that 
made  her  human,  and  the  husband  finds  himself  with 
a  creature  in  his  arms  at  which  his  soul  revolts.  I 
have  known  a  lady,  young  and  beautiful,  who  within  a 
month  of  her  marriage  was  an  inmate  of  a  lunatic 
asylum,  and  who,  though  years  have  since  passed,  has 
not  recovered,  and  in  all  probability  will  never  return 
to  home  and  husband. 

But  in  many  cases  the  evil  day  does  not  arrive  until 
middle  life ;  and  then,  when  the  fear  once  felt  has  worn 
away,  when  the  deception  practised  has  faded  from 
the  memory,  and  the  grave  admonition  of  the  physician 
is  forgotten,  the  son  in  whom  the  father  hoped  to  live 
again,  the  girl  on  whom  the  mother's  heart  is  set,  is 


MARRIAGE  AND  INSANITY.  113 

torn  from  the  family  circle  a  raving  maniac,  a  tortured 
epileptic,  a  drunken  criminal,  or,  happily,  a  suicide. 
Then  arise  sad  regrets,  but  it  is  too  late ;  the  laws  of 
Nature  have  been  ignored,  gratification  has  been  pur- 
chased, and  the  price  must  be  paid.  The  sins  of  the 
fathers  shall  be  visited  upon  the  children. 

As  to  who  should  marry,  it  is  clear  that  every  case 
must  be  considered  on  its  merits,  and  all  cases  in  which 
there  is  even  a  suspicion  of  gravity  should  be  sub- 
mitted to  the  family  physician,  or  some  one  specially 
learned  in  this  class  of  disease.  Happily  it  is  not 
incumbent  on  the  physician  to  advise  celibacy  in 
every  case  in  which  a  member  of  a  tainted  family 
appeals  to  him,  although  unfortunately  it  is  over  the 
marriage  of  very  few  such  he  can  pronounce  the 
benediction  of  science.  In  the  case  of  men  there 
cannot  be  a  doubt  that  in  some  cases  the  regularity 
and  comfort  of  a  happy  married  life  would  .be  of 
much  benefit,  and  greatly  reduce  the  liability  to  an 
outbreak  of  insanity,  or  to  a  relapse  in  one  who  had 
already  been  insane ;  but  at  best  marriage  partakes 
so  much  of  the  character  of  a  lottery,  that,  unfor- 
tunately, it  is  impossible  to  say  with  any  certainty 
whether  it  will  in  any  given  case  prove  happy  or  the 
reverse.  Besides,  it  must  be  remembered  that  a  man 
of  insane  temperament  does  not  make  the  most  patient 
and  long-suffering  of  husbands,  too  often  proving  to 
be,  like  the  sage,  "  gie  ill  to  live  wi'."  However,  if  the 
taint  be  not  too  deeply  marked,  and  more  especially 
if  the  risk  of  progeny  be  not  run,  marriage  with  a 


U4  MARRIAGE  AND  DISEASE. 

suitable  person  should  not  be  condemned.  Of  course 
in  all  suck  cases  the  second  party  to  the  contract 
should  be  made  to  understand  the  position  of  her 
future  husband,  and  the  risk  he  runs  of  at  any  time 
becoming  insane. 

But  such  permission  can  be  extended  to  men  alone, 
and  to  those  only  who  have  never  been  insane,  and  in 
whom  the  signs  of  the  insane  diathesis  are  not  pro- 
minent. To  those  who  have  already  had  an  attack  of 
insanity,  or  in  whom  the  insane  diathesis  is  distinctly 
marked,  it  is  impossible  for  the  physician,  having 
regard  to  the  health  and  welfare  of  the  community,  to 
recommend  marriage. 

As  to  women,  prohibition  must  be  still  more  strict. 
The  cares  and  trials  of  motherhood  are  so  trying  and 
severe  that  for  her  own  sake  no  woman  predisposed  to 
insanity  should  be  induced  to  add  so  greatly  to  her 
chances  of  losing  her  reason,  while  the  terrible  certainty 
with  which  the  mother  transmits  her  insane  tempera- 
ment to  her  children  renders  it  impossible  for  the 
physician  to  consent  to  her  putting  herself  in  the  way 
of  becoming  a  parent. 

This  is  all  that  can  be  done  at  present,  namely,  to 
give  advice  which  possibly  will  be  disregarded  by  the 
great  majority  of  those  to  whom  it  is  offered ;  but  ifc  is 
earnestly  to  be  hoped  that  before  long  the  Legislature 
will  do  something  to  stay  in  some  degree  the  propaga- 
tion of  insanity.  With  our  present  knowledge  of  the 
hereditary  character  of  this  disease  and  its  cruel  and 
pauperising  effect  upon  the  populace,  it  is  a  scandal 


MARRIAGE  AND  INSANITY.  115 

that  persons  who  have  been  several  times  insane,  and 
others  who  are  at  best  but  half-witted,  should  be 
allowed  to  marry  and  bring  forth  children  to  be  a  source 
of  expense  to  the  state  and  of  contamination  to  future 
generations. 


CHAPTER  IX. 

MARRIAGE  AND  DRUNKENNESS. 

"  The  morbid  craving  for  alcohol  is  common,  and  so  intense  that 
men  who  labour  under  it  will  gratify  it  without  regard  to  their 
health,  their  wealth,  their  honour,  their  wives,  their  children,  or 
their  soul's  salvation. 

.  .  .  After  they  have  become  dipsomaniacs,  in  the  present  state 
of  the  law  that  does  not  allow  legal  interference  with  their  liberty 
— I  say  it  with  deliberation — the  sooner  they  drink  themselves  to 
death  the  better.  They  are  a  curse  to  all  who  have  to  do  with 
them,  a  nuisance  and  a  danger  to  society,  and  propagators  of  a  bad 
breed."— CLOUSTON.* 

UNFORTUNATELY  it  is  not  necessary  to  say  much  in  the 
way  of  proof  of  the  transunssibility  of  the  "drink 
crave,"  as  this  neurosis  has  been  called.  It  speaks  for 
itself  from  every  grade  of  society  in  the  land,  from  the 
highest  to  the  lowest,  and  its  voice  gives  forth  no 
uncertain  sound.  With  instances  of  the  hereditary 
transmission  of  this  curse  every  one  is  only  too  familiar, 
and  I  need  not  soil  these  pages  with  any  long  record 
of  cases.  All  any  one  has  to  do  is  to  look  around  among 
his  friends  and  acquaintances  to  see  how  this  sin  in 
parents  is  visited  upon  the  children. 

The  hereditary  character  of  the  abnormal  condition 

*  "  Mental  Diseases,"  by  T.  S.  Clouston,  M.D. 


MARRIAGE  AND  DRUNKENNESS.  117 

of  which  habitual  drunkenness  is  the  outward  sign, 
although  firmly  established  and  universally  admitted, 
is  not  understood  as  it  should  be.  It  is  too  often  looked 
upon  as  a  vice  acquired  by  the  individual,  the  outcome 
of  voluntary  wickedness.  In  some  cases  this  is  doubtless 
true,  but  in  the  vast  majority  of  cases  inquiry  into  the 
family  history  will  reveal  the  presence  of  an  inherited 
taint,  such  families  generally  showing  the  neurotic  or 
insane  diathesis  more  or  less  distinctly  marked.  No 
grade  in  the  social  or  intellectual  world  is,  or  ever  has 
been,  free  from  this  disease,  and  if  we  study  the  family 
histories  of  the  great  ones  of  the  earth  who  have  fallen 
victims  to  it,  we  shall  find  that  there  the  cause  is  the 
same  as  amongst  the  obscure,  viz.,  that  they  have 
inherited  a  degenerate  nerve-condition  which  renders 
them  above  others  susceptible  to  this  and  allied 
neuroses,  such  as  epilepsy,  idiocy,  madness,  suicide, 
and  the  like.  In  fact,  the  dipsomaniac  and  habitual 
drunkard  are  very  often  as  much  sinned  against  as 
sinning,  inasmuch  as  they  have  inherited  an  unstable 
nervous  system  which  renders  them  liable  at  any  time 
to  fall  victims  to  this  vice  under  provocation  which, 
upon  a  stable  nervous  organisation,  would  be  powerless 
for  evil. 

Evidence  of  the  hereditary  character  of  this  and  other 
transmitted  pathological  conditions  is  seen  in  the 
tenacity  with  which  they  stick  to  their  victims  despite 
all  treatment.  An  acquired  vice  or  disease  often  gives 
way  before  persistent  judicious  treatment,  but  the 
innate  evil  is  only"  to  be  eradicated  by  treatment  carried 


Ii8  MARRIAGE  AND  DISEASE. 

on  through  several  generations.  Nevertheless,  the 
physician's  duty  is  to  make  the  attempt  in  every  case. 
In  some  few  his  efforts  will  be  rewarded  with  more  or 
less  success,  but,  unhappily,  in  the  vast  majority  they 
must  end  in  utter  failure,  for  the  simple  reason  that  he 
has  been  called  in  too  late.  As  Dr.  Oliver  Wendell 
Holmes  has  said,  "  the  doctor  should  have  been  called 
in  a  hundred  years  earlier." 

By  reference  to  Dr.  Stewart's  table,  already  given, 
it  will  be  seen  that  he  fixes  the  proportion  of  cases  of 
dipsomania,  in  which  he  found  hereditary  taint,  at  so 
high  a  figure  as  63.4  per  cent.,  which  is  above  that 
of  any  other  form  of  mental  disease  given. 

Of  late  years  the  Legislature  has  been  induced  to 
recognise  habitual  drunkenness  as  a  diseased  condition, 
and  has  made  certain  laws  for  the  temporary  confine- 
ment, care,  and  treatment  of  those  so  afflicted,  if  they 
themselves  sanction  it.  This,  however,  is  only  a  first 
step  in  the  right  direction,  but  the  path  is  entered 
upon,  and  we  may  hope  before  long  to  be  able  to 
detain,  as  we  now  can  a  raving  maniac,  those  unfortu- 
nate, semi-responsible  creatures  who  at  present  out- 
rage society  by  indulging  their  degraded  appetites, 
and  are  free  to  propagate  their  innate  degeneracy. 
And  when  that  day  arrives  we  shall  enter  upon  an 
era  in  which  it  will  be  possible  to  lessen,  in  some  part, 
not  only  habitual  drunkenness,  but  all  the  diseases, 
mental  and  bodily,  which  arise  from  the  abuse  of 
alcohol. 

I  need  not  harrow  the  feelings   of  the  reader  by 


MARRIAGE  AND  DRUNKENNESS.  119 

submitting  the  terrible  picture  of  the  drunkard's 
home.  It  has  been  done  in  poetry  and  prose  by 
many  masters,  and  been  depicted  upon  the  canvas 
of  the  painter,  and  upon  the  stage,  by  some  of  our 
greatest  artists.  I  shall  not  attempt  to  reproduce 
a  picture  so  well  known,  but  confine  myself  to  the 
matter-of-fact  statement  that  there  is,  perhaps,  no 
disease  or  vice,  hereditary  or  otherwise,  which  causes 
deeper  degradation  in  the  individual,  more  acute 
suffering  in  the  family  circle,  or  makes  a  greater 
call  upon  the  ratepayer,  than  does  this  of  habitual 
drunkenness.  It  is  a  curse  upon  the  community, 
for  it  is  the  starting-point  of  insanities,  epilepsies, 
crime,  and  endless  disease  in  posterity,  while  as  to 
the  individual,  there  is  no  other  diseased  condition 
known  which  so  utterly  and  rapidly  destroys  all  moral 
sense  ;  unless  it  be  epilepsy,  to  which  it  is  nearly  allied. 
The  victims  of  this  horrible  and  irresistible  craving 
may  at  first  honestly  express  shame  and  regret  for 
their  weakness,  and  for  the  disgrace  which  they  bring 
upon  those  who  should  be  dearest  to  them.  But  this 
spirit  is  only  too  short-lived,  soon  the  moral  nature 
— never  strong  in  such  persons — becomes  undermined, 
and  we  find  the  man  or  woman  who  but  a  short  time 
before  would  have  scorned  dissimulation  or  untruth, 
transformed  by  his  vice  to  a  cunning,  scheming  liar, 
without  the  remotest  sense  of  truth  or  honour,  and 
ready  to  do  absolutely  anything  to  gain  the  where- 
withal with  which  to  feed  his  thirst.  Once  on  the 
down-grade,  a  man  soon  reaches  a  level  where  honour, 


120  MARRIAGE  AND  DISEASE. 

truth,  and  even  common  honesty  are  unknown,  but 
in  woman  the  descent  is  even  more  rapid  and  terrible. 
Once  launched  upon  the  downward  journey  her  course 
is  not  to  be  stayed.  To  every  deep  she  finds  a  lower 
depth;  her  home,  her  husband,  her  family,  her  very 
honour,  are,  in  turn,  given  a  sacrifice  to  the  demon 
who  is  not  to  be  appeased. 

Yet  after  all  that  has  been  said  and  written  on 
this  subject,  these  unfortunate  creatures  are  still  mis- 
understood, and  when  their  inborn  vice  leads  them 
beyond  the  lines  laid  down  for  the  guidance  of  the 
mass,  they  are  haled  before  a  court  of  justice,  and 
punished  like  the  thief  or  other  law-breaker.  As 
might  be  anticipated,  this  seldom  if  ever  does  any 
good,  and  if  proof  of  this  were  wanted,  it  would  be 
found  in  the  regularity  with  which  they  return,  time 
after  time,  to  their  place  before  the  judgment- seat. 
Who  has  not  come  across  such  passages  in  the  reports 
of  the  proceedings  at  our  police  courts  as  these  : — 

"  A  shoe  rivetter  made  his  fiftieth  appearance  at  the 
police  court  this  morning,  when  he  was  charged  with 
being  drunk  and  disorderly;  and  having,  thanks  to 
the  holiday-time,  no  money  to  pay  for  his  'jubilee,' 
was  sentenced  to  seven  days." 

"Margaret  Hearn,  who  is  better  known  as  'Mog 
the  fireman,'  in  consequence  of  her  once  having  ascended 
a  fire-escape  when  under  the  influence  of  drink,  and 
excusing  herself  on  the  ground  that  she  did  so 
'because  she  had  heard  of  Jacob's  ladder,  and  wanted 
to  get  to  heaven/  was  charged,  before  Sir  John  Bridge, 


MARRIAGE  AND  DRUNKENNESS.  121 

at  the  Bow  Street  police  court,  yesterday,  with  being 
drunk  and  disorderly.  *  Mog1,'  who  entered  the  court 
in  her  characteristic  style,  said,  '  Ah,  Sir  John  Bridge, 
a  happy  New  Year  to  you!'  (Laughter.) — Constable 
343  E  stated  that  prisoner  was  found  drunk  in  Drury 
Lane. — Bush,  the  assistant  gaoler,  said  that  the  prisoner 
was  a  hard-working  woman  when  sober,  but  could 
not  keep  from  drink.  She  had  several  times  been 
placed  in  a  home,  and  on  one  occasion  had  stayed 
eleven  months,  and  at  the  end  of  that  period  re- 
ceived a  very  good  character.  She  had  spent  seven- 
teen years  out  of  the  last  twenty  in  prison. — Sir 
John  Bridge  thought  that  the  best  thing  that  could 
be  done  for  the  defendant  was  to  put  her  in  such  a 
position  that  she  could  not  have  access  to  drink. 
He  therefore  ordered  her  to  find  two  sureties  to 
keep  the  peace  for  six  months." — Daily  News,  9th 
January  1891. 

"  Margaret  West,  a  woman  of  the  same  class,  who 
was  said  to  have  been  before  a  magistrate  upwards 
of  fifty  times,  was  charged  with  being  drunk  and 
disorderly. — Defendant  (to  Mr.  Vaughan):  'It  is  all 
through  the  drink.' — Mr.  Vaughan  :  '  Then  why  do 
you  get  so  much  to  drink  ? ' — Defendant :  '  I  am  going 
to  have  a  try  this  time.' — Assistant-gaoler  Bush  said 
the  defendant  had  had  many  trials.  She  had  only 
recently  signed  the  pledge. — She  was  fined  forty 
shillings,  or  in  default  twenty-one  days'  imprisonment." 
— Daily  News,  27 th  January  1891. 

Such  persons  as  are  here  referred  to  are  not  re- 
sponsible agents,  and  the  state  should  recognise  that 


122  MARRIAGE  AND  DISEASE. 

fact  and  act  accordingly.  These  creatures  are  as 
helpless  to  fight  against  the  desire  for  drink  as  is 
the  hereditary  suicide  to  fight  against  the  fate  which 
impels  him  to  destruction,  and  their  punishment  is 
neither  more  just  nor  more  beneficial  than  would  be 
that  of  the  epileptic  for  creating  an  obstruction  by 
falling  down  upon  the  pavement.  Justice  will  not 
be  done  until  these  "  weak  ones,"  instead  of  being 
packed  off  again  and  again  to  prison,  and  being  per- 
mitted to  propagate  their  kind  in  the  intervals,  are 
sent  to  some  kind  of  industrial  home  or  penitentiary 
where  they  will  be  guarded  against  temptation,  where 
they  may  spend  the  full  value  of  their  labours  in 
any  comforts  they  please,  except  only  intoxicants,  and 
where  the  sexes  shall  be  kept  apart. 

The  fact  that  this  drink  crave  is  handed  down 
through  generations  in  most  instances,  can  in  no 
way  justify  any  man  or  woman,  however  clean  their 
family  bill  of  health  may  be,  in  thinking  that  their 
indulgence  in  this  vice  will  be  harmless  to  their  off- 
spring. It  must  be  remembered  that  acquired  char- 
acters tend  to  be  transmitted,  and  that  the  most 
vicious  hereditary  predisposition  existent  had  a  be- 
ginning in  the  healthy  individual.  Therefore,  those 
who  wish  to  live  in  posterity  and  see  their  children 
free  from  the  mark  of  the  beast — endowed  with  all 
the  heaven-born  attributes  which  raise  man  to  his 
high  position  above  all  other  creatures — must  never, 
even  temporarily,  degrade  their  nature.  True,  one 
indulgence  may  not  leave  an  impress  sufficient  to 


MARRIAGE  AND  DRUNKENNESS.  123 

appreciably  affect  the  children.  But  that  way  danger 
lies.  An  act  once  done,  whether  good  or  evil,  is 
easier  to  repeat  for  having  been  done  before.  The 
appetite  for  alcohol  is  only  too  easily  cultivated,  and 
the  man  or  woman  who,  through  weakness  or  thought- 
lessness, saturates  his  brain  with  it  frequently,  must 
not  be  surprised  if  his  sin  be  visited  upon  his  children 
as  idiocy,  epilepsy,  or  other  grave  nervous  or  physical 
deformity. 

From  the  earliest  times  it  has  been  known  that 
drunkenness  is  one  of  the  most  fruitful  sources  of 
idiocy,  and  also  of  physical  deformity  and  crime,  in 
the  children.  It  will  be  remembered  that  it  was  the 
drunkenness  of  Jupiter  when  Vulcan  was  conceived 
to  which  was  attributed  the  deformity  of  that  god. 
Dr.  Howe,  upon  careful  investigation,  found  that  fifty 
per  cent,  of  all  the  idiots  in  the  State  of  Massachusetts 
examined  by  him  were  the  children  of  intemperate 
parents.  Dr.  Fletcher  Beach  sets  down  drunkenness, 
either  alone  or  associated  with  some  other  obliquity 
of  nature,  as  the  cause  of  25  per  cent,  of  all  the 
idiocy  received  into  the  Darenth  Asylum,  and  with 
this  estimate  almost  every  other  observer  agrees. 
When  spoken  of  in  this  connection  it  is  generally 
chronic  drunkenness  that  is  meant,  and  certainly  a 
large  part  of  the  evil  caused  by  the  abuse  of  alcohol 
arises  from  chronic  or  continued  dissipation ;  never- 
theless it  must  be  clearly  understood  that  a  single 
debauch  may  result  in  the  idiocy  or  deformity  of 
the  child  then  conceived.  Cases  are  quite  common 


124  MARRIAGE  AND  DISEASE. 

where  a  temporarily  drtinken  person  has  begotten  an 
idiot  child.  As  Dr.  Maudsley  says,  "  Here,  as  else- 
where in  Nature,  like  produces  like,  and  the  parent 
who  makes  himself  a  temporary  lunatic  or  idiot  by 
his  degrading  vice,  propagates  his  kind  in  procreation, 
and  entails  on  his  children  the  curse  of  a  most  hope- 
less fate." 

A  striking  illustration  of  the  part  played  by  drunken- 
ness in  the  production  of  idiocy  is  to  be  found  in 
Norway.  In  that  country,  in  1825,  the  spirit  duty 
was  removed,  and,  consequently,  intemperance  at  once 
began  to  increase  alarmingly  among  the  people.  The 
result — or  rather  one  of  the  results — of  this  was, 
that  during  the  first  ten  years  following  this  regrettable 
event  insanity  increased  among  the  Norwegians  by 
50  per  cent.  This  was,  perhaps,  to  be  expected  under 
the  circumstances,  but  no  one  anticipated  that  the 
increase  of  congenital  idiocy  among  the  children  born 
during  the  same  decennial  period  would  amount,  as 
it  did,  to  1 50  per  cent. 

Drunkenness  is  one  of  the  greatest — perhaps  the 
greatest — agent  of  degeneration  at  work  among  the 
human  race,  and  to  it  must  be  attributed  much  of 
the  disease,  crime,  moral  obliquity,  and  general  de- 
generacy, physical,  mental,  and  moral,  which  we  find 
so  common  among  the  poorer  classes  in  all  large 
centres  of  civilisation.  The  dire  effects  of  this  agent 
of  degeneration  are  to  be  found  among  almost  every 
people  upon  the  face  of  the  earth,  and  in  some 
countries  they  are  simply  appalling.  In  Sweden,  for 


MARRIAGE  AND  DRUNKENNESS.  125 

instance,  which  is  one  of  the  most  drunken  countries 
in  the  world,  the  people  are  deteriorating  in  a  manner 
positively  alarming.  Some  years  ago  Dr.  Magnus 
Huss  wrote  of  the  Swedes : — "  The  whole  people  are 
degenerating :  insanity,  suicide,  and  crime  are  fright- 
fully on  the  increase;  new  and  aggravated  diseases 
have  invaded  all  classes  of  society ;  sterility  and 
premature  death  of  children  are  much  more  common ; 
and  congenital  imbecility  and  idiocy  are  in  fearful 
proportion  to  the  numbers  born." 

Here  is  a  history  of  a  family  which  well  shows  the 
degenerating  effect  of  drunkenness  upon  the  stock. 
First  Generation.     Father,  a  drunkard. 
Second   Generation.      Son,    a   drunkard.      Was   dis- 
gustingly drunk  on  his  marriage  day. 

Third  Generation.  Seven  grandchildren.  First  died 
of  convulsions.  Second  died  of  convulsions.  Third  was 
an  idiot  at  twenty-two  years  of  age.  Fourth,  melan- 
choliac  with  suicidal  tendency — became  demented. 
Fifth,  peculiar  and  irritable.  Sixth  has  been  insane 
repeatedly.  Seventh  nervous  and  depressed,  and  in- 
dulges in  most  despairing  anticipations  as  to  his  life 
and  reason.* 

This  drink-crave  takes  one  of  two  forms,  either 
habitual  drunkenness,  as  seen  in  the  toper,  who  is  at 
all  times  when  he  can  procure  the  drink  more  or  less 
intoxicated ;  or  dipsomania,  in  which  the  disease  takes 
on  a  periodic  character,  breaking  out  at  intervals  of 
one  to  six  or  nine  months,  and  rendering  the  individual 
*  "  Traitd  des  D^g&i&escences  "  (Morel). 


126  MARRIAGE  AND  DISEASE. 

wholly  irresponsible  while  the  paroxysm  lasts.  These 
two  forms  of  the  disease  are  totally  distinct,  the 
paroxysmal  seldom  running  into  the  habitual,  or  the 
reverse.  Indeed,  they  seem  to  attack  persons  of 
altogether  different  temperaments,  the  toper  being  in 
most  instances  a  slow,  obtuse,  lethargic  person  both 
in  mind  and  body,  with  but  little  power  of  will,  while 
the  true  dipsomaniac  is  generally  of  quick  excitable 
nature,  active  and  impulsive,  and  not  infrequently, 
before  his  disease  has  gone  too  far,  of  superior  intel- 
lectual ability.  In  both  cases,  however,  if  life  be  pro- 
longed the  end  is  the  same ;  for  while  the  dipsomaniac 
is  specially  liable  to  sudden  death  from  violence, 
suicide,  delirium  tremens,  &c.,  and  the  toper  to  disease 
of  such  organs  as  the  kidney,  heart,  liver,  and  brain, 
yet  if  they  be  ru|t  so  cut  off  each  will  arrive  at  the 
same  terminus,  vSSfcrcadual  weakening  of  the  mental 
faculties  terminating  in  complete  dementia.  In  some 
cases  epilepsy,  or  some  form  of  delusional  insanity  with 
attacks  of  maniacal  excitement,  may  precede  the  final 
dementia,  but  dementia  is  the  end.* 

The  distinction  between  these  two  forms  of  the  dis- 
ease is  also  marked  in  the  progeny.  The  offspring  of 
the  habitual  drunkard  generally  inherits  such  degenera- 
tive conditions  as  idiocy,  scrofula,  deaf-mutism,  the 
tendency  to  phthisis,  and  sometimes  epilepsy,  while 
that  of  the  dipsomaniac  is  liable  to  the  more  active 

*  According  to  the  returns  of  the  Commissioners  in  Lunacy, 
drunkenness  is  responsible  for  over  13  per  cent,  of  all  the  insanity 
coming  under  their  notice  during  the  ten  years  1879-1888  inclusive, 
20  per  cent,  of  the  males  and  7  per  cent,  of  the  females. 


MARRIAGE  AND  DRUNKENNESS.  127 

or  spasmodic  forms  of  nervous  disease,  as  suicide,  acute 
mania,  epilepsy,  and  crime.  The  children  of  both  are 
peculiarly  liable  to  convulsions,  and  death  at  an  early 
age  from  this  cause  is  a  frequent  occurrence  in  such 
families. 

This  diseased  condition,  like  any  other  hereditary 
predisposition,  may  remain  latent  for  a  generation  and 
reappear  unexpectedly  in  the  next,  but  it  is  seldom 
that  it  does  not  show  in  some  member  of  the  family, 
more  especially  in  those  children  which  were  begotten 
after  the  disease  had  been  active  in  the  parent ;  for, 
as  in  other  hereditary  diseases,  those  children  begotten 
after  the  disease  has  declared  itself  by  an  acute  attack 
in  the  parent,  are  much  more  liable  to  inherit  the  pre- 
disposition than  those  born  before  such  outbreak, 
these  latter  appearing  at  times  to^ecape  the  blight 
altogether.  jp 

It  is,  perhaps,  unnecessary  to  say  that  in  this  dis- 
ease, as  in  the  other  neuroses,  it  is  highly  improper 
that  those  in  whom  it  is  well  marked  should  become 
parents.  They  are  unfitted  by  their  inherited  infirmity 
to  undertake  the  duties  and  responsibilities  of  married 
life  ;  as  husbands  or  wives,  and  as  parents,  they  are 
equally  sad  failures.  They  are  always  improvident, 
and  their  early  death  often  saddles  the  community 
with  the  care  of  a  helpless  family,  while  of  the  chil- 
dren it  may  be  said  that  there  is  not  sufficient  chance 
of  their  being  useful  to  themselves  or  to  the  common- 
wealth to  justify  their  being  brought  into  existence. 
Above  all,  there  should  be  no  intermarriage  among 


128  MARRIAGE  AND  DISEASE. 

persons  inheriting  this  disposition.  If  there  be  any 
person  whose  partner  should  be  without  taint  it  is 
assuredly  him  that  carries  within  him  the  germ  of 
such  an  insidious  and  degrading  disease  as  this  drink 
crave. 

In  this,  as  in  the  other  insanities,  the  disease  is 
much  more  dangerous  in  the  mother  than  in  the 
father,  which  is  a  sound  reason  why  the  daughters  of 
drunken  parents,  often  fascinating  by  their  nighty, 
excitable,  vivacious,  neurotic  manner,  should  be  care- 
fully avoided  by  men  in  search  of  mothers  for  their 
children.  The  man  who  marries  the  daughter  of  a 
drunkard,  not  only  endangers  his  own  self-respect 
and  happiness,  but  entails  to  his  children  a  wretched 
inheritance  of  degradation  and  suffering.  On  the 
other  hand,  no  woman  should  be  induced  to  marry  a 
confirmed  drunkartl,  and  the  disposition  and  char- 
acter of  the  sons  of  such  should  be  most  carefully  in- 
quired into  before  any  engagement  is  entered  upon. 
This  is  one  of  the  few  instances  in  which  a  long 
engagement  is  not  to  be  condemned,  for  frequently 
the  engaged  man  loses  that  desire  to  appear  well  in 
the  eyes  of  all  women,  which  actuates  most  single 
men,  and  displays  much  of  his  real  character. 

Not  a  few  of  the  best  of  our  women  throw  them- 
selves away,  and  ruin  their  whole  lives,  by  marrying 
confirmed  rakes  and  drunkards,  in  the  hope,  the  almost 
insane  hope,  of  saving  them  from  the  fate  to  which 
they  have  been  foreordained  by  a  bad  inheritance.  The 
spirit  which  prompts  to  such  devotion  and  self-sacrifice 


MARRIAGE  AND  DRUNKENNESS.  129 

is  not  to  be  treated  lightly.  An  attribute  so  Christ- 
like  is  not  to  be  rudely  pushed  aside  by  cold,  calculat- 
ing reason,  without  a  word  of  sympathy.  In  some  few 
cases,  doubtless,  men  have  been  snatched  as  brands 
from  the  burning  by  noble  women  who  have  risked 
all  in  the  hazard,  and  such  wife-heroes  should  stand  in 
the  forefront  of  the  ranks  of  Nature's  nobility.  Yet 
I  would  point  out  that  the  attempt  so  rarely  ends  in 
salvation,  and  so  frequently  in  complete  failure  and 
despair,  that  such  an  experiment  can  in  no  case  be 
advised;  and  further,  that  while  one  might  not  feel 
justified  in  interfering  with  attempts  at  the  reclama- 
tion of  the  erring,  if  only  the  fate  of  the  volunteer 
were  at  stake,  he  feels  it  his  duty  to  speak  when  he 
remembers  the  children  whose  fate  is  also  staked  upon 
the  hazard.  It  may  be  argued  that  a  person  has  a 
right  to  risk  happiness,  even  life  itself,  in  the  hope 
that  some  other  may  be  benefited,  but  it  cannot  be 
said  that  a  person  should  have  legal  or  moral  right  to 
jeopardise  the  future  of  a  whole  family,  to  satisfy  any 
instinct,  however  noble. 


.CHAPTER  X. 

MARRIAGE  AND  EPILEPSY. 

"  Epilepsy  is  pre-eminently  an  hereditary  affection."— J.  KUSSELL 
REYNOLDS,  M.D. 

EPILEPSY  is  one  of  the  most  fearful  diseases  which  attack 
man.  From  the  earliest  times  it  has  been  more  feared 
than  even  madness  itself.  Among  the  ancient  peoples, 
the  Jews,  Greeks,  and  Romans,  this  disease  was  the 
foundation  upon  which  was  built  the  doctrine  of  de- 
moniacal possession,  and  certainly  the  symptoms  of 
the  disorder,  as  observed  during  one  of  the  terrible 
outbursts  of  maniacal  fury  to  which  epileptics  are  at 
all  times  liable,  are  enough  to  justify  a  belief  in  such 
a  doctrine,  in  any  ignorant  and  superstitious  people. 
Dr.  Clouston  says,  "No  demon  could  by  any  possi- 
bility produce  more  fearful  effects  by  entering  into  a 
man,  than  I  have  often  seen  result  from  epilepsy," 
and  with  this  every  one  will  agree  who  has  witnessed 
one  of  those  terrific  outbursts,  which  so  often  convert 
such  sufferers  into  very  demons. 

Although,  in  the  majority  of  cases,  not  what  might 
be  called  a  rapidly  fatal  disease,  epilepsy  is  one  of  the 
most  cruelly  painful  and  hopeless  afflictions  which  can 
come  upon  man.  It  unfits  the  person  it  attacks,  even 


EPILEPSY.  131 

from  the  earliest  stages  of  its  progress,  for  most  of 
the  duties  of  life.  It  is  liable  at  any  moment  to 
render  him  unconscious,  to  precipitate  him  into  fire  or 
water,  or  from  a  height,  while  it  may  in  a  moment 
convert  a  rational  being  into  a  very  angel  of  destruc- 
tion. Like  an  evil  genius  it  is  ever  present  with  its 
victim,  lying  in  wait  to  strike  him  down  at  the  most 
inopportune  time  and  place.  It  may  even,  without 
the  slightest  warning,  put  an  end  to  the  life  of  its 
victim  by  the  virulence  of  its  attack,  or,  which  is 
more  common,  by  accident  or  suicide.  This  fact, 
however,  is  hardly  to  be  deplored ;  indeed,  such  a  ter- 
mination is  almost  to  be  preferred  to  the  fate  which 
awaits  the  greater  number  of  such  sufferers,  who  in 
time  sink  into  drivelling  idiocy,  or  some  of  the  most 
degraded  and  repulsive  forms  of  vacuous  dementia. 

It  may  be  truly  said  of  the  epileptic  that  he  is 
doubly  cursed.  Racked  in  body,  and  robbed  of  mind, 
he  soon  becomes  the  most  pitiable  creature  on  earth. 
If  he  be  so  unfortunate  as  to  survive,  to  escape  all 
the  pitfalls  which  his  disease  spreads  in  his  path,  too 
often  he  is  only  spared  for  a  worse  fate.  All  along 
he  is  liable  to  convulsions,  which  distort  the  features 
beyond  recognition,  convulse  every  muscle  in  the 
body,  and  rob  him  for  the  time  being  of  consciousness. 
These  attacks  are  usually  followed  by  deep  sleep,  but 
they  may  be  followed,  preceded,  or  replaced,  by  out- 
bursts of  the  wildest  frenzy,  which  frequently  takes 
a  homicidal  or  suicidal  form.  When  these  outbursts 
occur,  the  epileptic  will  make  ferocious  and  murderous 


132  MARRIAGE  AND  DISEASE. 

assaults  upon  any  one  within  his  reach,  and  not  a  few 
slay  relatives  near  and  dear  to  them,  or  destroy  their 
own  lives,  during  such  attacks.  These  outbursts  may 
occur  at  any  time  or  place.  'they  may  even  appear 
before  the  intellect  has  been  sufficiently  weakened  or 
disordered  to  attract  attention,  and  for  this  reason  no 
one  who  has  ever  been  epileptic  should  be  entrusted 
with  the  care  of  children,  or  put  in  any  other  position 
where  opportunity  is  offered  for  the  gratification  of 
such  homicidal  impulse.  The  intellectual  course  of 
the  epileptic  between  the  fits — whether  physical  or 
mental — is  always  a  downward  one.  Each  attack 
leaves  the  whole  mental  apparatus  more  or  less  clouded 
and  exhausted,  and  as  this  is  never  wholly  recovered 
from,  each  attack  marks  a  permanent  impairment  of 
mind — a  step  on  the  darkening  path  which  leads 
down  to  intellectual  death.  In  certain  cases  the 
maniacal  attacks  rarely  appear,  and  the  course  of  the 
disease  is  marked  only  by  the  convulsive  seizures. 
But  in  these  cases  the  result  is  the  same.  If  life  be 
sufficiently  prolonged,  the  same  dark  destination  is 
reached,  whether  the  downward  journey  be  a  gradual 
descent,  or  be  accomplished  by  a  series  of  bounds,  each 
marked  by  an  outburst  of  murderous  frenzy.  In  either 
case  the  goal  is  a  degraded  imbecility. 

Epileptics  are  also  specially  liable  to  mental  dis- 
orders of  the  more  ordinary  character,  that  is,  mental 
disorder  which  continues  in  the  intervals  between  the 
fits.  They  frequently,  at  an  early  period,  suffer  from 
auditory  and  visual  hallucinations,  and  such  cases  are 


EPILEPSY.  133 

most  liable  to  uncontrollable  impulses,  homicidal  and 
suicidal,  and  to  maniacal  outbursts.  Later,  delusions 
more  or  less  permanent  are  often  developed,  which 
are  the  cause  of  not  a  few  of  the  motiveless  murders 
constantly  occurring.  In  fact,  the  majority  of  epileptics 
are  really  insane  between  the  attacks.  Esquirol  * 
examined  385  epileptic  women,  with  a  view  to  dis- 
covering to  what  extent  mental  disease  existed  among 
them,  and  he  discovered  that  only  a  sixth  were  free 
from  intellectual  derangement :  "  but  nearly  all  these," 
he  said,  "  were  irritable,  peculiar,  and  easily  enraged." 
From  this  it  is  clear  that  no  person  who  has  ever  had 
"  fits  "  is  to  be  depended  u^pon,  and  to  entrust  young 
children  or  others  to  their  care,  as  is  often  done  by 
mothers  and  others  in  authority  out  of  misplaced  pity, 
is  little  short  of  criminal. 

It  is  most  unfortunate,  then,  that  this  dread  disease, 
which  degrades  its  victims  to  a  level  beneath  that  of 
the  beasts  that  perish,  is  not  properly  understanded 
of  the  people.  Not  only  the  ignorant,  but  a  great 
number  of  those  who  can  lay  claim  to  some  education, 
know  so  little  of  hereditary  disease  that  they  look 
upon  epilepsy  occurring  in  children  merely  as  an  un- 
avoidable affliction  depending  entirely  upon  teething, 
worms,  or  some  such  infantile  trouble,  which  for  some 
unknown  reason  is  often  continued  into  adult  life. 
In  the  same  way,  when  it  makes  its  appearance  later 
in  life,  it  is  set  down  as  the  result  of  a  fright,  the 
"  change  of  life  "  (puberty),  or  some  such  cause.  Not 

*  "  Maladies  Mentales,"  vol.  i. 


134  MARRIAGE  AND  DISEASE. 

once  in  a  hundred  cases  is  it  attributed,  as  it  should 
be,  to  inherited  predisposition.  This,  I  say,  is  un- 
fortunate, for  ignorance  of  the  true  character  of  the 
disease  can  have  but  one  effect — its  propagation. 

The  people  should  be  taught  that  epilepsy  is,  par 
excellence,  an  hereditary  affliction,  that  it  is  nearly 
related  to  idiocy,  and  madness,  and  paralysis,  and 
deaf-mutism,  and  that  no  member  of  any  family  in 
which  it  is  known  to  be  should  be  considered  a  person 
who  can  with  safety  become  a  parent.  Of  course,  there 
are  cases  of  epilepsy  which  arise  from  mechanical 
injury  to  the  head,  or  fright,  or  have  their  exciting 
cause  or  starting-point  *tn  such  irritation  of  the 
nervous  system  as  that.,  experienced  during  dentition 
or  the  approach  of  puberty.  Yet  it  must  never  be 
forgotten,  that  even  in  these  cases  much  depends 
on  family  taint,  and  that  epilepsy  seldom  attacks  a 
child  who  is  not  the  unfortunate  inheritor  of  a  neur- 
otic temperament.  Indeed,  were  it  otherwise,  most 
children  must  be  epileptic,  for  all  suffer  the  nervous 
irritation  and  excitement  consequent  on  dentition 
and  the  approach  of  puberty  and  adolescence,  and  if 
all  were  equally  predisposed,  all  must  equally  suffer. 
But  while  all  suffer  these  irritations  few  become 
epileptic,  and  it  is  perfectly  clear  from  inquiry  into 
the  family  histories  of  those  who  do,  that  they  are  pre- 
disposed by  inheritance,  else  they  too  would  escape. 

Epilepsy  is,  in  fact,  one  of  the  most  strongly  heredi- 
tary of  all  diseases.  In  this  respect,  it  is  on  a  footing 
with  the  suicidal  impulse,  melancholia,  drunkenness, 


EPILEPSY.  135 

and  gout.  Dr.  J.  Russell  Reynolds  found  heredity 
well  marked  in  31  per  cent,  of  his  cases,  and  says, 
"  I  am  therefore  led  to  believe  that  an  hereditary 
tendency  to  epilepsy  is  much  more  common  than  it  is 
generally  represented  to  be  by  recent  writers  on  the 
subject."  Echeverria  said  28  per  cent,  of  all  the  cases 
coming  under  his  notice  were  hereditary.  Webster 
in  England,  and  Esquirol  in  France,  declared  that  a 
third  of  all  cases  of  epilepsy  depended  on  family  taint, 
while  Dr.  Gowers,  one  of  the  greatest  authorities  on 
the  subject,  asserts  that  no  less  than  36  per  cent,  of 
all  epilepsy  has  hereditary  transmitted  predisposition 
as  a  foundation. 

I  myself  have  records  of  143  consecutive  cases  of 
epilepsy,  as  they  appeared  for  admission  into  an  asylum 
for  the  insane.  There  were  93  males  and  50  females. 
Of  the  males,  34.4  per  cent,  were  members  of  families 
in  which  either  epilepsy  or  insanity  of  some  descrip- 
tion had  already  appeared ;  of  the  females,  50  per 
cent,  belonged  to  the  same  class;  while  in  39.8  of 
the  total  of  both  sexes  there  was  positive  evidence  of 
hereditary  taint.  I  would  also  remark  that  in  a  con- 
siderable number  of  my  cases,  no  history  of  any  kind 
could  be  obtained. 

Although  epilepsy  is  frequently  transmuted  to  in- 
sanity, idiocy,  chorea,  hysteria,  the  drink- crave,  and 
other  diseased  conditions  of  the  nervous  system  in 
transmission,  it  is  remarkable  for  the  regularity  with 
which  it  is  transmitted  unchanged  in  some  families. 
Dr.  Gowers  found  in  nearly  75  per  cent,  of  all  his 


136  MARRIAGE  AND  DISEASE. 

hereditary  cases,  either  epilepsy  alone,  or  epilepsy 
combined  with  insanity  of  some  kind  in  the  direct 
line  of  ancestors,  and  instances  a  case  in  which  no 
fewer  than  fourteen  members  of  a  family  were  afflicted 
with  the  disease.  Yet  notwithstanding  the  fact  that 
epilepsy  is  thus  transmitted  unchanged  with  wonder- 
ful regularity — almost  approaching  in  this  respect  the 
suicidal  impulse — the  taint  not  infrequently  takes 
other  form  in  the  offspring.  As  Dr.  Clouston  remarks, 
"Hereditarily  ordinary  insanity  and  epilepsy  are  closely 
allied.  The  son  or  daughter  of  an  epileptic  is  just 
as  likely  to  be  idiotic,  weak-minded,  drunken,  or  in- 
sane, as  to  be  epileptic ;  and  certainly,  the  children  of 
families  with  strong  insane  heredity  are  very  com- 
monly epileptic."  *  In  truth,  there  are  few  families 
showing  the  insane  diathesis  which  have  not  epileptics 
among  their  members.  When  the  tendency  to  in- 
sanity becomes  deeply  marked  in  a  family,  epilepsy 
with  idiocy,  paralysis,  squint,  physical  deformity,  or 
deaf-mutism  added  on,  is  almost  certain  to  make  its 
appearance  in  some  of  the  children,  and  when  this 
stage  of  degeneration  is  reached  the  extinction  of  the 
family  is  at  hand,  such  children  being  generally  sterile. 
Two  families  of  which  I  have  notes  are  good 
examples  of  the  fatal  effect  of  insanity,  combined 
with  epilepsy,  upon  the  family.  One  is  that  already 
mentioned  at  page  97,  where,  out  of  a  family  of  nine 
children,  six  died  of  "fits"  during  the  first  year  of 
life,  and  of  the  survivors,  one  was  an  idiot  and  the 
*  Loc.  cit. 


EPILEPSY.  137 

other  two  were  "  weak  " — i.e.,  imbecile.  Of  that  family 
there  will  never  be  another  generation.  The  second 
was  the  family  of  an  epileptic,  who  married  a  woman 
of  the  insane  diathesis.  The  family  tree  is  given  at 
page  1 08,  and  shows  the  disastrous  effect  of  this 
parental  combination  upon  the  offspring. 

In  this  case  the  epilepsy  of  the  father,  combined 
with  the  insane  taint  in  the  mother,  came  very  nearly 
reaching  the  necessarily  fatal  type  and  exterminating 
the  family  in  one  generation.  Of  the  five  wretched 
children  born,  the  first  was  epileptic,  the  second  epi- 
leptic and  insane,  the  third  an  impotent  idiot,  and 
the  fifth  insane — a  melancholiac  with  strong  suicidal 
tendencies.  In  fact,  the  family  was  so  saturated  with 
nervous  disease,  that  the  end  was  almost  reached. 

It  must  not  be  imagined  that  the  above  family 
records  are  in  any  way  exceptional;  unfortunately, 
they  are  only  too  common.  I  take  the  two  below 
from  Dr.  Fletcher  Beach,  of  Darenth  Asylum  : — 

CASE  I. 


M. 
Died  mad. 

1 

Imbecile. 

1 

Irrit 

I 

able. 

i.                    i 

Died  of  brain  disease. 

i. 

Imbecile. 

Epileptic. 

Epileptic. 

1       1       1       1       1 
i              345 

I   I 

All  seven  died  in  convulsions. 


Here  the  father,  in  whom  the  family  taint  was  repre- 
sented by  mere  irritability,  begot  a  family  of  ten  who 


I38  MARRIAGE  AND  DISEASE. 

were  probably  the  last  of  a  degenerate  race.  Of  the 
ten,  seven  died  in  childhood  of  convulsions,  two  were 
epileptic,  and  the  remaining  one  was  an  impotent 
imbecile. 

CASE   II.* 


F. 

A  suicide. 


Insane. 


-F. F. 


Insane.  Epileptic. 


K. 

Insane. 

I 


Excitable.  DulL  Epileptic  imbecile. 

Here,  again,  we  are  within  measurable  distance  of,  if 
not  actually  arrived  at,  the  close  of  the  family's  exist- 
ence. Had  the  man,  the  son  of  the  suicide,  had  the 
good  sense  or  good  fortune  to  have  married  a  woman 
of  sound  family,  instead  of  the  sister  of  an  epileptic, 
who  was  to  become  insane  herself  later  in  life,  it  is 
possible  that  reversion  to  the  healthy  type  might  have 
taken  place,  at  least  in  some  of  the  children,  and  the 
fate  of  the  family  been  other  than  it  was. 

From  all  these  family  histories  it  is  evident  that 
epilepsy  is  symptomatic  of  a  lower  grade  of  degenera- 
tion than  that  found  in  the  ordinary  insanities.  It 
most  frequently  makes  its  appearance  in  members  of 
families  which  have  shown,  or  are  showing,  other 
phases  of  degeneration,  as  idiocy,  drunkenness,  defor- 

*  British  Medical  Journal,  May  28,  1887. 


EPILEPSY.  139 

mity,  criminality,  cancer,  scrofula,  and  insanity.  Few, 
indeed,  are  the  families  which  become  extinct  without 
displaying  epilepsy  in  some  of  their  latest  represen- 
tatives. It  is  the  constant  associate  of  idiocy,  which 
is  the  lowest  form  of  development  consistent  with  a 
continuance  of  life.  M.  Herpin,  the  distinguished 
French  physician,  calculated  that  epilepsy  occurred  in 
six  out  of  every  1000  of  the  general  population  (and 
even  this  was  thought  by  some  to  be  too  high  au 
average)  ;  whereas  Drs.  Ireland,  Langdon  Down,  and 
others  found  that  close  on  25  per  cent,  of  all  idiots  are 
epileptic,  that  is,  250  to  the  1000  against  six  to  the 
IOOO  among  the  ordinary  population.  The  frequency 
with  which  epilepsy  attacks  the  drunken,  the  instinctive 
criminal  class,  the  scrofulous,  and  the  insane  is  notorious. 
From  the  figures  of  the  Commissioners  in  Lunacy  we 
find  that  90  to  the  IOOO  is  the  rate  at  which  it  is  to  be 
found  among  the  insane  of  these  countries,  while  the 
studies  of  Lombroso  and  others  have  proved  pretty 
clearly  that  anthropologically  the  epileptic  and  the 
criminal  are  very  nearly  akin. 

In  the  great  mass  of  cases  epilepsy  makes  its  appear- 
ance during  childhood,  this  being  the  more  certainly 
true  where  the  disease  is  distinctly  hereditary.  Dr. 
Eussell  Reynolds  found  that  83.3  per  cent,  of  hereditary 
epilepsy  appeared  under  fifteen  years  of  age,  while  of 
the  non-hereditary  only  46. 1  per  cent,  appeared  under 
that  age.  He  also  expressed  the  opinion  that  the 
disease  appears  earlier  in  life  the  more  strong  and 
direct  the  taint.  He  gives  the  average  age  at  which 


140  MARRIAGE  AND  DISEASE. 

it  appears  in  the  male  as  fourteen,  and  in  the  female 
eleven  years. 

According  to  the  Registrar-General's  returns  the 
average  number  of  deaths  annually  registered  as  due 
to  epilepsy  during  the  past  ten  years  has  been  consider- 
ably over  2500.  These  figures,  however,  can  give  no 
idea  of  the  prevalence  of  the  disease  among  the  popula- 
tion, for  it  is  a  very  small  proportion  of  those  who  have 
been  epileptic  whose  deaths  are  directly  due  to  that 
disease,  and  fewer  still  which  are  registered  as  being 
so.  Not  a  few  epileptics  come  to  their  death  by  vio- 
lence, either  accidental  or  suicidal,  to  which  they  are 
more  liable  than  any  other  class  of  the  community, 
and  it  is  well  known  that  a  vast  number  of  epileptics 
annually  succumb  to  such  degenerative  diseases  as 
phthisis.  Besides,  how  many  of  the  enormous  num- 
ber (2O,OOO  to  25,000)  of  deaths  annually  registered 
under  the  head  "  Convulsions "  are  due  to  inherited 
epilepsy  it  is  impossible  to  say;  that  a  very  great 
number  are  is  absolutely  certain.  Perhaps  if  we  were 
to  assign  to  inherited  epileptic  taint  a  half  of  these 
so-called  deaths  from  convulsions,  and  say  that  about 
12,000  deaths  are  annually  due  to  this  disease,  we 
should  be  well  within  the  mark.  And  of  these  12,000, 
the  majority  would  be  those  of  tender  years,  whom 
inheritance  of  a  neurotic  temperament  had  doomed 
to  an  early  death.  The  amount  of  infantile  suffering 
represented  by  these  figures  can  only  be  surmised. 

And  now  arises  the  question  of  marriage.  One 
thing  is  certain,  and  that  is,  "  epileptics  decidedly  ought 


EPILEPSY.  141 

not  to  marry."  Great  numbers  of  these  afflicted  ones 
are  at  present  detained  in  asylums  and  workhouses, 
but  this  at  present  only  can  be  done  when  the  disease 
has  gone  so  far  as  to  affect  the  mind  sufficiently 
seriously  to  render  the  sufferer  insane  in  the  eye  of 
the  law,  and  before  this  stage  is  reached  the  epileptic 
is  frequently  the  parent  of  a  family. 

Laws  aiming  at  preventing  epileptics  becoming 
parents  have  been  known  in  times  past,*  and  seeing 
to  what  an  extent  our  idiots,  criminals,  suicides, 
drunkards,  and  insane  are  recruited  from  the  offspring 
of  the  epileptic,  I  think  the  Legislature  would  be  fully 
justified  in  forbidding  the  confirmed  epileptic  becoming 
a  parent,  as  a  proceeding  inimical  to  the  weal  of  the 
commonwealth. 

Legislation  to  this  end  is,  perhaps,  too  much  to 
expect  just  at  present,  but  the  day  when  such  a  law 
will  appear  on  the  statute-book  is  fast  approaching. 
The  divine  right  of  kings  to  govern,  once  as  firmly 
fixed  as  any  canon  of  the  Church,  has  disappeared 
before  the  onward  march  of  education  and  enlighten- 
ment, and  so  shall  what  some  are  pleased  to  call 
"the  divine  right  of  procreation."  It  may  be  said 
that  it  is  not  necessary  to  interfere ;  that  if  we  leave 
the  whole  affair  to  Nature  she  will  right  herself. 
Undoubtedly.  But  that  is  exactly  what  we  do  not 
do.  If  left  to  themselves,  these  wastrels  from  Nature's 
workshop  could  not  survive,  they  would  succumb  to 
their  own  unfitness.  But  this  happy  consummation 
*  Boethius,  "  De  Veterum  Scotorum  Moribus,"  lib.  i 


142  MARRIAGE  AND  DISEASE. 

we  use  every  endeavour  to  postpone.  Nature  will  not 
even  tolerate  the  unfit:  we  not  only  cherish  them, 
but  strive  to  cultivate  them,  and  the  result  of  our 
labours  is  to  be  found  in  our  asylums  for  the  blind, 
the  deaf,  the  idiotic,  the  insane,  and  in  our  prisons. 
By  all  means  let  us  comfort  and  protect  the  helpless, 
it  is  our  duty :  but  let  us  stop  there.  If  the  course 
of  Nature  were  not  interfered  with,  legislation  would 
be  uncalled  for. 

For  the  present,  however,  we  must  do  the  best  we 
can  to  stay  the  ravages  of  this  avoidable  suffering 
and  poverty  by  education,  by  pointing  out  to  the 
people  that  the  man  or  woman  who  knowingly  takes 
for  husband  or  wife  one  so  diseased  as  to  rob  the 
children  of  a  reasonable  chance  of  health,  is  com- 
mitting an  outrage  against  God  and  Nature. 


CHAPTER  XI. 

SYPHILIS. 

SYPHILIS  cannot  rightly  be  called  an  hereditary  disease, 
for  the  reason  that  it  is  not  handed  down  from  parent 
to  child  through  many  generations,  nor  does  it  ever 
skip  a  generation  to  appear  in  that  following.  Indeed, 
it  is  still  doubtful  whether  syphilis  as  syphilis  ever 
reaches  the  third  generation.  But  although  the  disease 
is  seldom  or  never  transmitted  as  syphilis  beyond 
the  children  of  the  infected  parent,  it  is  often  the 
starting-point  of  degenerate  conditions  which  are 
transmitted  through  many  generations,  and  cause 
grave  deterioration  in  the  family  stock.  On  this 
ground,  then,  it  deserves  brief  consideration  in  these 
pages. 

Syphilis  is  a  disease  which  affects  the  whole  system. 
No  tissue  or  organ  is  safe  from  its  attack.  When 
severe,  and  still  more  surely  when  engrafted  upon  a 
scrofulous,  neurotic,  or  otherwise  already  degenerate 
constitution,  this  disease  so  impoverishes  the  system, 
robs  the  tissues  and  organs  of  their  vitality,  that  a 
condition  allied  to  the  scrofulous  diathesis  is  estab- 
lished. This  condition  is  transmitted  to  the  offspring 


144  MARRIAGE  AND  DISEASE. 

— often  without  a  single  symptom  of  the  specific 
disease — and  there  forms  the  basis  of  epilepsies,  scrofula, 
idiocy,  physical  deformities,  and  other  pathological 
characters  in  them  and  their  offspring.  Until  recently 
it  was  believed  by  many  that  the  scrofulous  diathesis 
in  the  child  was  but  another  form  of  the  syphilitic 
cachexia  of  the  parent.  The  recent  discovery  of  the 
tubercle  bacillus  with  its  distinctive  characteristics, 
proves  conclusively  that  there  is  no  kinship  between 
syphilis  and  tubercular  disease,  but  it  in  no  way  affects 
the  belief  that  the  impoverished  condition  of  the 
syphilitic  and  his  offspring  is  almost  identical  with 
that  condition  known  as  the  scrofulous  diathesis. 
Certain  it  is  that  the  miserable  devitalised  children 
of  the  syphilitic  offer  a  peculiarly  favourable  field 
for  the  growth  and  development  of  disease  germs,  and 
as  that  of  tubercle  is  one  having  a  special  affinity  for 
the  tissues  of  those  low  in  vital  energy,  a  great  number 
of  such  children  fall  victims  to  tubercular  disease. 
As  a  factor  in  the  production  of  general  deterioration 
of  the  family,  no  other  agent  at  present  known  can 
be  compared  with  this  disease — syphilis. 

From  the  time  of  the  formation  of  the  primary  sore 
at  the  seat  of  inoculation  of  the  syphilitic  poison,  or 
perhaps  earlier,  up  till  two  or  three  years  after  the 
last  signs  of  what  are  known  as  the  "  secondary 
symptoms,"  the  person  infected  will  transmit  the 
disease  itself  to  any  child  born  or  begotten,  and  in 
cases  which  have  been  neglected — in  which  a  strict 
and  scientific  course  of  treatment  has  not  been  carried 


SYPHILIS.  145 

out — the  infected  person  may,  even  after  ten,  twelve, 
or  more  years,  have  syphilitic  children.  While  in 
some  instances  the  disease  poison  takes  such  hold 
upon  the  system  as  to  rob  the  individual  altogether 
of  his  or  her  highest  function,  viz.,  that  of  continuing 
the  species. 

There  is  no  other  disease  the  poison  of  which  has 
so  malignant  and  lasting  an  effect  upon  the  constitu- 
tion of  man  as  syphilis,  and  the  person  who  has  been 
once  infected,  is  never  safe  either  as  an  individual, 
or  as  a  parent.  He  may,  certainly,  after  a  course  of 
careful  treatment  enjoy  good  health  and  beget  healthy 
children,  and  imagine  himself  clear  of  the  disease 
and  its  evil  effects;  but  even  after  years  he  may 
beget  a  tainted  child,  or,  if  he  catch  some  other  dis- 
order, its  course  may  be  affected,  and  grave  compli- 
cations arise  because  of  the  old  taint.  Excesses  on 
his  part  will  be  punished  by  prolonged  attacks  of 
ill-health,  and  injuries  which  would  speedily  heal  in 
the  healtby,  in  him  will  give  rise  to  tedious  and 
exhausting  ulcerations,  diseases  of  the  bones,  and  a 
hundred  other  distressing  troubles. 

We  may  briefly  consider  this  disease  under  two 
heads,  as  Acquired  Syphilis  and  Hereditary  Syphilis, 
at  the  same  time  glancing  at  the  degenerate  condi- 
tions we  have  hinted  at  as  following  in  its  wake. 

ACQUIRED  SYPHILIS. — In  order  to  acquire  this  dis- 
ease it  is  necessary  that  a  quantity  of  the  living  poison 
be  introduced  into  the  system.  The  quantity  may  be 
infinitesimal,  and  is  generally  introduced  through  some 


146  MARRIAGE  AND  DISEASE. 

cut,  scratch,  abrasion,  or  other  break  in  the  cutaneous 
or  mucous  surface.  Of  course  in  the  vast  majority  of 
cases  the  poison  is  received  during  unclean  sexual 
connection,  but  the  public  should  understand  that  the 
disease  may  be,  and  at  times  is,  acquired  in  other 
ways,  as  we  shall  see  later. 

About  three  to  four  weeks  after  the  introduction  of 
the  poison,  a  sore,  having  decided  characteristics  of  its 
own,  appears  at  the  seat  of  infection,  and  soon  after 
the  lymphatic  glands  in  the  neighbourhood  of  the  sore 
become  enlarged.  These  do  not  suppurate,  nor  are 
they  painful.  Later  the  glands  in  distant  parts  of  the 
body  may  also  become  enlarged,  and  this  is  a  distinc- 
tive sign  that  the  disease  is  true  syphilis. 

The  primary  sore  generally  heals  without  much 
trouble,  and  about  six  weeks  later  what  are  called  the 
"secondary  symptoms"  appear.  The  person  feels  out 
of  sorts,  becomes  feverish  and  has  pains  in  the  head, 
and  shortly  a  rash  appears  on  the  skin  in  the  form  of 
red  spots,  or  papules.  The  rash  may  be  very  plentiful 
all  over  the  body,  or  may  consist  of  only  a  few  spots, 
but  its  plentifulness  or  the  reverse  cannot  be  taken  as 
any  criterion  of  the  severity  or  mildness  of  the  attack. 
About  this  time  the  throat  becomes  painful  and  in- 
flamed, and  sores  form  there,  the  hair  gets  thin — in 
fact,  may  all  be  lost,  and  intractable  affections  of  the 
nails  may  appear. 

At  this  stage  the  patient  is  most  dangerous  to  those 
around  him.  The  discharge  from  the  sore  throat,  or 
from  any  other  sore  upon  the  body,  even  the  blood 


SYPHILIS.  147 

itself,  being  loaded  with  the  poison,  which  has  multi- 
plied a  thousandfold  in  the  system  since  its  introduc- 
tion, will  convey  the  disease.  It  is  therefore  obvious 
that  the  very  greatest  care  should  be  taken  to  prevent 
the  spread  of  the  poison.  All  cups,  spoons,  and  other 
utensils  used  by  such  persons  should  be  thoroughly 
cleansed  before  being  used  by  others;  all  dressings, 
rags,  &c.,  contaminated  by  contact  with  the  sick  one, 
should  be  burnt,  and  intimate  relations  with  him  gene- 
rally should  be  strictly  avoided.  Kissing  is  a  common 
means  of  conveying  infection,  and  the  use  of  the  same 
cup,  spoon,  towel,  &c.,  is  not  infrequently  attended  with 
a  like  result,  consequently  the  greatest  care  is  necessary 
in  every  case,  and  as  from  the  nature  of  the  disease  the 
patient's  friends  and  relatives  are  rarely  aware  of  their 
danger,  the  duty  of  observing  every  possible  precaution 
devolves  upon  the  infected  one  himself. 

The  rash  upon  the  skin,  the  sore  throat,  the  dropping 
of  the  hair,  together  with  various  other  troubles,  make 
up  what  are  known  as  the  "  secondary  symptoms,"  and 
until  the  disappearance  of  the  last  of  these  the  danger 
of  infection  to  those  around  continues.  Any  child 
begotten  or  borne  during  this  period,  or  within  from 
two  to  three  years  after  the  disappearance  of  these 
symptoms,  is  almost  certain  to  be  diseased,  however 
carefully  the  affection  has  been  treated. 

After  the  disappearance  of  the  secondary  symptoms, 
if  the  disease  have  been  carefully  and  methodically 
treated  from  the  first  under  the  advice  of  a  competent 
medical  man,  comparatively  good  health  may  be  once 


148  MARRIAGE  AND  DISEASE. 

more  attained,  and  with  attention  to  the  laws  of  health 
this  desirable  condition  may  be  continued,  perhaps, 
through  life.  But  if  the  person  who  has  suffered  from 
syphilis  violate  the  laws  of  health,  even  in  a  mild 
degree,  his  apparent  good  health  will  almost  assuredly 
break  down,  and  he  will  become  the  victim  of  most 
intractable  and  distressing  disorders,  both  internal  and 
external.  These  are  called  the  "  tertiary  symptoms," 
and  often  depend  upon  a  diseased  condition  of  the 
internal  organs,  in  which  the  slowly  working  disease 
poison  has  caused  the  growth  of  masses  of  lowly  orga- 
nised tissue  which  interfere  with  the  proper  functions 
of  the  organs  affected. 

Other  symptoms,  less  grave,  perhaps,  but  no  less 
distressing,  may  also  make  their  appearance  about  this 
time,  such  as  ulcerations  of  the  cutaneous  and  mucous 
surfaces  and  diseases  of  the  bones.  It  is  therefore  of 
the  greatest  importance  that  the  person  who  has  had 
syphilis  should  give  strict  attention  to  all  hygienic 
laws,  and  make  every  endeavour  to  keep  his  health  at 
as  high  a  level  as  possible. 

All  persons,  however,  are  not  equally  liable  to  the 
later  symptoms  of  syphilis.  "  The  constitution  of  the 
person  will  materially  influence  the  phenomena  which 
supervene  during  syphilis,  e.g.,  the  gouty,  rheumatic, 
tuberculous,  and  cancerous  temperaments  will  modify 
the  syphilitic  lesions  and  degenerations;  while  con- 
stitutional syphilis  in  its  turn  modifies  the  character 
of  ordinary  diseases."*  Such  degenerate  constitutional 
*  Sir  William  Aitken,  op.  dt. 


SYPHILIS.  149 

states  as  those  mentioned  render  the  system  less  able  to 
withstand  the  onset  of  so  malignant  and  impoverishing 
a  disease  as  syphilis,  consequently  it  runs  a  more  ter- 
rible and  destructive  course ;  the  new  poison  naturally 
attacks  the  weakest  tissues  in  such  enfeebled  constitu- 
tions, or  rather,  it  seems  to  combine  with  the  already 
existing  constitutional  disease  to  evolve  a  deeper  de- 
generation. Thus  in  the  gouty  the  poison  attacks  the 
joints  and  the  great  blood-vessels,  and  "  the  lesions 
ultimately  assume  the  form  of  degenerations ; "  in  the 
rheumatic  the  tendons,  joints,  eyes,  and  bones  suffer 
most  severely;  in  the  scrofulous  those  tissues  and 
organs  in  which  ulceration  is  most  liable  to  set  up, 
or  where  tubercles  are  most  likely  to  deposit,  are  most 
deeply  affected,  and  so  on  with  other  family  degenera- 
tions. 

On  the  other  hand,  the  enfeebled,  impoverished,  and 
diseased  condition  which  is  invariably  produced  by 
syphilis,  renders  the  system  infinitely  more  liable  to 
the  attack  of  other  diseases.  And  when  these  do 
occur  their  course  is  perverted,  grave  complications 
arise,  and  the  chances  of  some  chronic  ailment  being 
left  behind,  or  of  the  illness  proving  fatal,  are  largely 
increased. 

HEREDITARY  SYPHILIS. — As  we  have  seen,  true 
syphilis  may  be  transmitted  from  parent  to  child. 
In  every  case  this  may  take  place  for  a  period  extend- 
ing over  two  to  three  years  from  the  time  of  infec- 
tion, and  in  some  cases  even  after  the  lapse  of  ten, 
fifteen,  or  more  years.  True  hereditary  syphilis  is 


ISO  MARRIAGE  AND  DISEASE. 

that  which  is  transmitted  from  one  or  other  parent 
at  the  time  of  conception.  A  child  may  be  infected 
with  syphilis  at  any  period  between  conception  and 
birth,  by  a  mother  who  has  during  that  time  acquired 
the  disease,  but  in  such  cases,  although  the  child  is 
syphilised  before  it  is  born,  the  disease  is  not  true 
hereditary  syphilis,  nor  is  it  nearly  so  deadly  as  where 
it  is,  so  to  speak,  begotten  with  the  germ. 

Hereditary  syphilis  is  one  of  the  most  common 
causes  of  abortion,  and  is  also  the  cause  of  an 
enormous  number  of  the  deaths  which  occur  during 
the  first  year  or  two  of  life.  The  virulence  of  the 
poison  is  often  so  great  that  the  child  is  killed  shortly 
after  conception,  and  is  born  dead.  In  other  cases, 
where  the  poison  is  a  shade  less  virulent,  the  child  is 
born  with  the  disease  actually  upon  it,  and  often  only 
comes  into  the  world  to  be  carried  to  the  grave. 
Others,  again,  are  born  without  active  symptoms  of 
the  disease,  wretched,  puny  creatures,  who  develop  the 
disease  within  a  short  time  of  birth,  and  of  whom  a 
large  percentage  succumb  after  a  short  and  wretched 
existence.  Another  class  are  those  in  whom  the 
poison  seems  to  have  left  a  general  blight ;  the  vitality 
of  these  is  at  so  low  a  level  that  their  development — 
physical  and  mental — is  not  only  retarded  but  limited. 
Such  creatures  develop  slowly ;  at  eighteen  or  twenty 
years  of  age  they  are  still  children,  and  such  they 
remain  during  life.  Still  another  class  show  the  evil 
influence  of  their  parents'  disease  in  their  own  de- 
formity. These  have  malformed  limbs,  club-feet, 


SYPHILIS.  151 

hare-lip,  cleft  palate,  spina-bifida,  water  on  the  brain, 
paralysis,  and  various  forms  of  idiocy.  Some  may 
think  that  in  charging  these  deformities  to  any  large 
extent  against  parental  syphilis,  I  am  going  too  far. 
To  these  I  would  point  out  that  it  is  not  an  assertion 
founded  upon  my  own  comparatively  limited  experi- 
ence, but  is  the  view  held  by  Professor  Fournier,  one 
of  the  greatest  authorities  upon  syphilis  which  the 
world  at  present  possesses,  and  of  many  others  only 
less  eminent. 

In  syphilis  the  nature  of  the  disease  forbids  our  ever 
getting  a  full  and  honest  history  of  its  effects  upon 
the  offspring,  and  for  this  reason  statistics  on  the 
subject  are  rare.  Of  its  terrible  effect  upon  the 
children  we  have,  nevertheless,  ample,  if  fragmentary 
evidence.  The  best  that  I  can  at  present  lay  my 
hand  upon  is  that  published  by  Dr.  B.  Tarnowsky 
(Der  Kinder arzt,  October  1890).  This  distinguished 
observer  takes  a  most  gloomy  view  of  the  effects  of 
syphilis  upon  succeeding  generations.  According  to 
his  experience,  71  per  cent,  of  women  suffering  from 
syphilis  either  give  birth  to  dead  children,  or  bear 
children  which  die  within  a  year  of  birth.  This 
high  percentage  closely  agrees  with  that  of  Professor 
Fournier,  which  I  shall  give  presently.  In  his  in- 
teresting and  able  paper,  Dr.  Tarnowsky  records  the 
terrible  history  of  three  families,  whose  fathers  had 
contracted  syphilis  six,  five,  and  four  years  respectively 
before  marriage.  All  these  men  appeared  to  be  cured 
when  married,  and  all  their  children  were  born  healthy, 


152  MARRIAGE  AND  DISEASE. 

that  is,  they  showed  no  symptoms  of  syphilis.  In 
these  three  families  there  were  twenty-two  children, 
and  of  these  only  one  grew  up  to  healthy  maturity. 
Five  were  premature,  three  died  of  inflammation  of 
the  membranes  of  the  brain  before  attaining  their 
second  year,  two  were  imbecile,  two  were  idiotic,  one 
had  numerous  signs  of  degeneration,  one  was  weak  in 
intellect,  one  insane,  two  hysterical,  one  epileptic,  one 
a  deaf-mute,  and  two  had  water  on  the  brain.  Of  the 
thirteen  still  alive  when  these  statistics  were  taken, 
eight  were  incapable  of  earning  their  living,  the  re- 
maining five  being  sickly  and  nervous.  All  three 
families,  he  points  out,  were  of  the  respectable  com- 
mercial class;  none  of  the  children  were  exposed  to 
the  hardships  which,  in  the  case  of  peasants  and 
artisans,  may  cause  infantile  diseases  falsely  attributed 
to  syphilis.  Dr.  Tarnowsky  has  collected  other  family 
histories  scarcely  less  dreadful,  and  his  conclusion  is, 
that  syphilis  in  a  parent  may  be  the  cause  of  a  long 
series  of  most  serious  diseases  —  scrofula,  rickets, 
nervous  disorders,  &c.,  and  the  offspring  at  the  best 
are  often  weak,  useless  members  of  society. 

All  syphilitic  children  are  ill- developed,  miserable, 
puny  things  even  when  not  deformed.  Their  little  faces 
are  withered,  pale,  and  pinched  ;  their  noses  become  flat, 
their  heads  are  large,  their  foreheads  square,  their  cheeks 
seared  with  the  scars  of  old  sores ;  and  over  all  there 
is  a  strange  uncanny  look  of  age  and  suffering  which 
is  repulsive,  and  strangely  at  variance  with  the  cherub- 
like  freshness  and  innocence  of  the  healthy  infant. 


SYPHILIS.  153 

These  wretched  children,  being  robbed  of  a  large 
part  of  their  vitality,  are  predisposed  to  all  sorts  of 
disease.  They  are  peculiarly  liable  to  diseases  of  the 
nervous  system,  and  a  great  number  of  them  die  from 
inflammation  of  the  membranes  of  the  brain  and 
from  convulsions,  while  the  number  that  succumbs  to 
tubercular  disease — more  especially  of  the  bones  and 
joints,  as  seen  in  spinal  and  hip-joint  disease — shows 
how  good  a  field  their  weak  nature  offers  to  all  the 
micro-organisms  of  degeneration  and  death. 

But  although  death  is  so  busy  in  the  ranks  of  the 
hereditarily  syphilitic  during  the  early  years  of  life, 
many  of  them  drag  through  a  more  or  less  miserable 
existence  to  what  is  to  them  maturity.  Among  these 
the  standard  of  development,  physical  and  mental,  is 
generally  low.  In  middle  life — they  never  reach  old 
age — they  succumb  rapidly  to  acute  febrile  disease, 
or  the  nervous  system  gives  way  and  they  become 
insane  or  epileptic.  Under  circumstances  which  would 
prove  harmless  to  the  robust,  they  develop  phthisis 
and  various  scrofulous  disorders,  and  to  their  offspring 
they  transmit  their  degenerate  natures  and  so  deteriorate 
the  race. 

In  some  cases  the  child  who  has  inherited  syphilis 
does  not  show  any  outward  or  active  sign  of  it  in  the 
early  years  of  life,  and  occasionally  it  is  not  until 
the  fifth,  tenth,  fifteenth,  or  even  twentieth  year  that 
the  inherited  disease  wakes  up  to  activity  (Fournier). 
Such  cases  are,  however,  rare.  In  the  vast  majority 
of  cases  where  syphilis  has  been  inherited,  the  dis- 
11 


154  MARRIAGE  AND  DISEASE. 

ease  makes  its  appearance  during  the  firsj;  year  or  two 
of  life,  and  either  kills  its  victim,  or  leaves  him  feeble 
and  blighted,  an  easy  prey  to  some  other  affection. 

As  might  be  expected,  all  the  graver  forms  of 
degeneration  following  or  arising  from  syphilis  are 
to  be  found  at  their  best — or  rather  worst — among 
the  poor  in  our  large  towns,  where  the  disease  is 
neglected,  and  where  it  has  so  many  other  agents  of 
degeneration  at  work  to  help  it.  The  ravages  of 
syphilis  among  the  poor  of  our  great  cities  has  long 
been  recognised,  but  its  influence  as  a  degenerating 
agent  among  the  lower  classes  has  not  yet  been  fully 
appreciated.  Aided  by  drunkenness,  poverty,  and 
squalor,  syphilis  is  largely  responsible  for  that  residuum 
of  humanity  to  be  found  in  the  dark  places  of  our 
great  centres  of  population,  from  which  are  recruited 
the  consumptive,  the  scrofulous,  the  epileptic,  the 
prostitute,  the  idiot,  the  habitual  drunkard,  the  in- 
stinctive criminal,  and  the  insane. 

The  fearful  malignancy  of  the  syphilitic  poison  is 
best  seen  among  semi-barbarous  tribes  where  it  has 
been  introduced,  and  where  no  treatment  mitigates 
its  virulence.  In  such  cases,  a  healthy  people  will 
soon  become  a  degenerate,  disease-ridden  race,  their 
constitutional  condition  often  becoming  nearly  allied 
to  that  of  the  leper.  Indeed,  some  of  our  very  highest 
authorities  have  recently  gravely  questioned  whether 
leprosy  be  not  really  one  of  the  disease  degenerations 
which  follow  neglected  syphilis.  At  present,  syphilis, 
with  its  following  of  degenerative  disease,  bids  fair  to 


SYPHILIS.  155 

exterminate  the  inhabitants  of  some  of  the  South  Sea 
Islands. 

As  I  have  said,  hereditary  syphilis  may  be  trans- 
mitted from  either  parent.  Statistics  go  to  prove 
that  in  a  majority  of  cases  the  infection  comes,  as  we 
might  anticipate,  from  the  father.  As  to  whether  that 
ot  paternal  or  maternal  origin  be  the  more  virulent, 
opinions  differ,  but  at  present  the  weight  of  evidence 
appears  to  be  strongly  in  favour  of  the  maternal  being 
the  more  fatal.  Professor  Fournier  found  the  inherited 
disease  to  be  fatal  to  the  offspring  in  the  following 
varying  proportions  according  to  its  source : — Paternal 
28  per  cent.,  maternal  60  per  cent.,  and  where  both 
parents  were  syphilitic,  the  mortality  reached  68.5  per 
cent,  of  the  pregnancies. 

Not  only,  then,  is  this  disease  the  cause  of  an 
enormous  amount  of  ill-health,  suffering,  and  family 
decay  among  every  rank  of  our  population,  but  it  is 
.also  the  cause  of  death  in  thousands  of  children,  born 
and  unborn,  annually.  "In  London  alone,  during 
twelve  years  (1854-65),  there  were  3370  deaths  from 
syphilis  among  children,  and  2587  of  these  were  under 
a  year  old."  How  many  children  were  killed  before 
birth  by  this  disease  during  these  years  can  only  be 
surmised,  but  that  the  above  figures  represent  only 
a  very  small  proportion  of  the  total  of  the  child  life 
so  destroyed  we  may  be  absolutely  certain. 

As  to  the  source  of  this  disease  it  is  unnecessary  to 
say  a  word.  It  is  known  to  all  that  prostitution  is 
the  poisoned  fountain  from  which  this  contamination 


I $6  MARRIAGE  AND  DISEASE. 

is  continually  being  carried  to  the  people.  Prostitu- 
tion is  older  than  history,  and  has  existed  in  all 
nations  and  among  all  peoples ;  only  varying  in  degree 
as  the  laws  affecting  the  relationship  of  the  sexes 
varied.  All  attempts  at  the  suppression  of  this  vice 
have  signally  failed  ;  and  it  is  to  be  feared  that  so 
long  as  human  nature  remains  what  it  is,  future  efforts 
in  that  direction  are  foredoomed  to  like  failure.  Pros- 
titution is  but  the  vicious  overflow  of  that  passion 
which  is  the  foundation  of  family  and  home,  and 
which  calls  forth  all  that  is  best  and  highest  in 
our  nature,  as  well  as  much  that  is  bad.  So  long  as 
that  passion  exists,  so  long  will  this  evil  continue. 
That  fact  we  must  recognise,  and  having  recognised, 
the  duty  of  society  and  the  state  is  clear.  It  is  not 
to  close  our  eyes  against  the  evil  we  find  it  impossible 
to  remedy,  and,  ostrich-like,  try  to  believe  that  what 
we  do  not  see  does  not  exist;  but,  having  admitted 
the  incurable  nature  of  the  evil,  to  set  about  mitigat- 
ing its  evil  effects  in  every  way  that  is  possible.  How 
this  social  vice  might  be  shorn  of  its  terrible  effect 
upon  the  guilty  and  the  innocent  alike,  has  been 
pointed  out  again  and  again,  but  until  hypocritical 
self-righteousness  takes  a  less  prominent  place  in  our 
creed,  science  will  not  be  permitted  to  limit  the  ravages 
of  this  disease  in  England. 

"  In  the  eyes  of  every  physician,  and,  indeed,  in  the 
eyes  of  most  Continental  writers  who  have  adverted 
to  the  subject,  no  other  feature  of  English  life  ap- 
pears so  infamous,  as  the  fact  that  an  epidemic,  which 


SYPHILIS.  157 

is  one  of  the  most  dreadful  now  existing  among 
mankind,  which  communicates  itself  from  the  guilty 
husband  to  the  innocent  wife,  and  even  transmits  its 
taint  to  the  offspring,  and  which  the  experience  of 
other  nations  conclusively  proves  may  be  vastly  dimi- 
nished, should  be  suffered  to  rage  unchecked,  because 
the  Legislature  refuses  to  take  official  cognisance  of 
its  existence,  or  proper  sanitary  measures  for  its  re- 
pression."* Infamous  indeed !  The  historian  has  hit 
upon  the  proper  word. 

As  to  preventive  measures,  the  one  great  law  is — 
Be  chaste.  Lead  a  pure  and  virtuous  life,  and  fear 
not  this  evil.  As  to  accidental  infection,  the  greatest 
care  should  be  taken  when  it  is  known  or  suspected 
that  any  one  in  the  household  is  suffering  from  the 
disease.  The  use  of  the  same  cups,  spoons,  towels, 
tobacco-pipes,  &c.,  &c.,  should  be  carefully  avoided, 
and  the  act  of  kissing  should  never  be  indulged  in. 
In  the  case  of  a  syphilitic  infant,  the  parents  should 
not  permit  friends  to  kiss  it — should  any  be  so  in- 
clined— and  they  should  on  no  account  engage  for 
such  a  child  a  wet-nurse.  Virtuous  women,  the  wives 
of  respectable  men,  often  become  infected  from  diseased 
children  they  have  been  engaged  to  suckle.  No 
medical  man  will  sanction  such  a  proceeding  as  the 
wet-nursing  of  a  syphilitic  child.  To  submit  any 
person  to  such  grave  danger  of  infection  is  a  heart- 
less and  cruel  outrage,  and  when  wittingly  committed 
should  be  a  criminal  offence. 

*  Lecky's  "  History  of  European  Morals." 


1 58  MARRIAGE  AND  DISEASE. 

On  the  other  hand,  too  great  care  cannot  be  taken 
in  seeing  that  any  wet-nurse  engaged  for  a  healthy- 
child  is  not  infected  with  this  disease,  for,  as  the 
diseased  infant  can  convey  it  to  the  nurse,  so  can  a 
diseased  nurse  convey  it  to  the  healthy  infant.  Parents 
should  never  engage  any  person  as  wet-nurse  until 
their  own  medical  attendant  has  examined  and  ap- 
proved of  her. 

As  to  the  danger  of  infection  through  vaccination, 
which  has  been  vastly  magnified  by  the  opponents  of 
that  operation,  little  need  be  said  here.  That  syphilis 
can  be,  and  has  been  conveyed  by  vaccination,  is  un- 
fortunately true;  but  as  the  operation  of  vaccination 
is  always  in  the  hands  of  qualified  medical  men,  I 
have  only  to  say  that,  with  even  reasonable  knowledge 
and  care,  such  an  accident  is  next  to  impossible,  and 
that  the  vaccinator  who  conveys  syphilis  should  in 
all  cases  be  held  responsible. 

In  the  next  place,  I  would  point  out  that  there  is 
no  disease  known  in  the  course  of  which  more  ab- 
solutely marvellous  results  can  be  attained  by  good 
treatment,  or  more  disastrous  results  by  bad,  than  in 
syphilis.  For  this  reason,  the  person  who  has  any 
reason  to  suspect  that  he  has  been  infected,  should  at 
once  apply  to  a  respectable  medical  practitioner,  avoid- 
ing as  he  would  poison  all  those  ignorant  vultures 
who  advertise  their  nostrums,  and  feed  and  grow  fat 
on  the  weak,  the  credulous,  and  the  ignorant.  A  con- 
siderable number  of  the  very  worst  cases  which  turn 
up  in  the  hospital  and  the  consulting-room,  are  those 


SYPHILIS.  159 

which  have  been  altogether  neglected,  or,  what  is  even 
worse,  maltreated  by  advertising  charlatans.  Shame, 
and  fear  of  exposure,  drive  many  of  the  erring  into 
the  net  spread  for  them  by  these  quacks,  and  once 
there,  escape  is  more  difficult  than  might  be  expected ; 
in  fact,  to  any  but  the  strong-minded — few  of  whom 
are  to  be  found  in  the  position — it  is  next  to  impos- 
sible. Many  of  these  ruffians,  when  they  have  learnt 
the  name,  position,  and  resources  of  their  victim, 
proceed  in  the  most  deliberate  manner,  by  the  aid 
of  threats  of  exposure,  to  levy  black-mail.  Thus  the 
person  who  puts  himself  into  the  power  of  such 
sharpers  is  liable  to  financial  as  well  as  physical  ruin ; 
the  secret  which  would  have  been  absolutely  safe  in 
the  keeping  of  any  medical  man  being  made  the  lever 
for  extorting  sums  which  often  exceed  what  would 
suffice  to  fee  the  most  eminent  specialist  that  could 
be  chosen. 

In  cases  of  inherited  syphilis,  the  unfortunate  child 
should  at  once  be  placed  under  medical  treatment. 
Such  children  will  require,  during  infancy  and  youth, 
and,  indeed,  all  through  life,  particularly  jealous  care 
and  treatment  to  secure  a  reasonable  development, 
and  prevent,  if  possible,  the  onset  of  epilepsy,  scrofula, 
phthisis,  or  some  other  disease  of  degeneration. 

As  to  the  question  of  marriage,  experience  has 
shown  that  it  is  not  safe  for  the  person  who  has  been 
syphilitic  to  marry  for  a  considerable  time  after  the 
reception  of  the  poison.  Mr.  Jonathan  Hutch inson, 
our  greatest  authority  in  Eogland  on  the  subject,  lays 


160  MARRIAGE  AND  DISEASE. 

it  down  that  marriage  may  be  permitted  "two  years 
after  the  disappearance  of  the  last  of  the  secondary 
symptoms."  This  would  be  about  two-and-a-half  years 
after  the  time  of  infection.  Professor  Fournier  extends 
the  time  of  prohibition  to  "  three  to  four  years  "  from 
the  time  of  infection,  and  certainly  safety  is  on  that 
side.  Of  course,  these  rules  only  apply  to  those  cases 
which  have  been  carefully  and  skilfully  treated. 

Finally,  no  person  who  has  had  syphilis  should  ever, 
tinder  any  circumstances,  marry  without  the  sanction 
of  his  medical  adviser. 


CHAPTER    XII. 

DEAF-MUTISM. 

"  Ordinary  deaf -mutism  is  closely  allied  to  idiocy,  and  is  one  of 
the  hereditary  neuroses.  To  me  it  is  a  physiological  sin  that 
marriages  between  such  persons  should  be  legal." — CLOUSTON.* 

THERE  is  still  some  difference  of  opinion  as  to  the 
hereditary  character  of  deaf-mutism,  and  some  might 
even  demur  to  its  being  given  a  place  in  a  work 
treating  solely  of  hereditarily  transmitted  affections.' 
This  difference  of  opinion  depends  largely  upon  the 
want  of  discrimination  with  which  cases  are  collected 
and  classified.  To  understand  the  part  played  by 
family  predisposition  in  the  production  of  this  con- 
dition, all  cases  of  deaf-mutism  should  be  divided  with 
great  care  into  two  classes.  First,  those  in  whom 
the  deafness  is  the  result  of  congenital  defect;  and 
second,  those  in  whom  deafness  follows  some  injury 
to  the  auditory  apparatus  before  or  shortly  after  the 
power  of  speech  has  been  attained.  Nearly  the  whole 
of  the  cases  making  up  the  first  class  we  shall  find 
dependent  upon  parental  taint;  whereas  in  the  second 
*  Op.  dt.,  p.  286. 


1 62  MARRIAGE  AND  DISEASE. 

class  the  deafness,  and  consequent  ignorance  of  spoken 
language  (except  in  those  cases  in  which  the  deafness 
is  caused  by  scrofulous  disease,  syphilis,  &c.),  are  no 
more  hereditary  than  is  the  blindness  of  the  child 
whose  eye  has  been  poked  out  with  a  stick.  The 
two  classes  should  be  kept  distinct.  The  first  is  by 
far  the  larger,  but  a  sufficient  number  belong  to  the 
second  to  materially  affect  statistics ;  and  until  the 
two  classes  are  clearly  distinguished,  opinions  will 
differ  as  to  the  part  played  by  hereditary  taint  in  the 
production  of  deaf-mutism. 

With  the  second  class  we  have  nothing  here  to  do. 
Such  cases  generally  arise  from  some  destructive  in- 
flammatory affection  of  the  middle  ear — as  that  which 
frequently  follows  scarlet  fever — and  so  may  occur  in 
any  child.  In  the  infant  they  are  easily  distinguish- 
able from  the  congenital  cases ;  but  later  in  life, 
when  the  history  becomes  garbled,  it  is  often  difficult, 
if  not  impossible,  to  distinguish  to  which  class  a  case 
properly  belongs. 

Congenital  deaf-mutism  is,  on  the  other  hand,  a  con- 
stitutional affection.  It  is  a  degenerate,  a  markedly 
degenerate  condition,  and  therefore  a  sign  that  the 
family  in  which  it  appears  has  started  on  the  down 
'grade  toward  decay,  except  in  such  cases  as  it 
depends  upon  some  temporary  depraved  condition 
in  the  parents  at  the  time  the  child  was  begotten,  as 
drunkenness,  &c. 

It  is  true  that  deaf-mutism  is  not,  like  the  suicidal 
impulse  and  some  other  conditions  that  we  have  con- 


DEAF-MUTISM.  163 

sidered,  transmitted  in  a  majority  of  cases  unchanged 
from  parent  to  child.  The  family  defect  which  shows 
in  the  child  as  congenital  deafness  may  be  met  with 
in  the  ancestors  or  collateral  relatives  as  idiocy, 
insanity,  blindness,  epilepsy,  scrofula,  physical  de- 
formity, or  the  like,  for  these  are  but  the  various  out- 
ward signs  of  that  general  tendency  to  degeneration 
which  mark  such  families.  It  is  not  necessary  to 
trace  deaf-mutism  as  deaf-mutism  through  several  gene- 
rations of  the  family  line  to  prove  its  dependence  on 
hereditary  taint.  It  is  but  the  sign  by  which  the 
innate  degeneracy  makes  itself  known  to  the  outer 
world,  and  this  sign  will  vary  in  successive  generations, 
and  even  in  different  members  of  the  same  generation. 
Thus  in  the  family  of  the  deaf-mute,  inquiry  will 
frequently  discover  idiotic,  epileptic,  blind,  or  scrofulous 
brothers  and  sisters ;  dipsomania,  insanity,  epilepsy, 
phthisis  or  imbecility  in  the  parents  or  earlier  ances- 
tors, and  like  conditions  in  collateral  branches  of  the 
family.  It  is  only  in  exceptional  cases  that  we  can 
expect -a  reappearance  of  the  identical  phenomena  of 
degeneration  in  each  new  generation,  and  that  of  deaf- 
mutism  is  not  one  of  these. 

It  must  not,  however,  be  thought  that  it  is  at  all 
uncommon  to  find  this  particular  outward  sign  of 
family  decay  transmitted  unchanged  from  parent  to 
child,  or  appearing  in  several  members  of  the  same 
family.  Occasionally  a  whole  family  is  found  deaf 
and  dumb.  Bibot,  who  argues  strongly  in  favour  of 
the  hereditary  character  of  deaf-mutism,  found  that 


164  MARRIAGE  AND  DISEASE. 

of  148  pupils  in  the  Deaf  and  Dumb  Institution  of 
London,  there  was  one  in  whose  family  there  were 
five  deaf-mutes,  one  in  whose  family  there  were  four, 
eleven  in  each  of  whose  families  there  were  three,  and 
nineteen  who  each  had  a  brother  or  sister  similarly 
afflicted  with  themselves.  These  figures  Rlbot  con- 
siders in  themselves  conclusive  proof  of  the  frequent 
hereditary  character  of  the  affection;  and  certainly 
when  we  find  in  thirty-two  out  of  148  cases,  almost 
22  per  cent. — this  evidence  of  the  condition  not  being 
confined  to  the  individual,  but  present  in  other 
members  of  the  family — the  case  in  favour  of  the 
hereditary  origin  of  the  affection  is  strong.  But  much 
more  positive  evidence  of  the  frequent  hereditary  trans- 
mission of  deaf -mutism  is  to  be  found  in  the  article  on 
"Vital  Statistics"  in  the  Keport  of  the  Irish  Census 
Commissioners.  This  writer  discusses  at  considerable 
length  the  subject  of  congenital  deaf -mutism,  and  pro- 
duces a  mass  of  evidence  which  Sir  William  Turner, 
in  his  address  before  the  Anthropological  Section  of 
the  British  Association  in  1889,  asserted  "proves  that 
it  is  often  hereditarily  transmitted." 

This  writer  states  that  "in  the  Irish  census  for 
1871,  3297  persons  were  returned  as  deaf-mutes,  and 
in  393  cases  the  previous  or  collateral  branches  of 
the  family  were  also  mute.  In  211  of  these  the  con- 
dition was  transmitted  through  the  father,  in  182 
through  the  mother."  Here  we  have  almost  exactly 
12  per  cent,  of  direct  transmission  through  one  or 
other  parent.  But  this  writer  does  not  stop  here ;  he 


DEAF-MUTISM.  165 

gives  other  important  figures.  He  says  : — "  In  379 
instances  there  were  2  deaf-mutes  in  the  family,  in 
191  families  3,  in  53  families  4,  in  21  families  5?  in  5 
families  6,  and  in  each  of  2  families  no  fewer  than  7 
deaf-mutes  were  born  to  the  same  parents." 

Now,  it  is  not  too  much  to  infer,  when  a  degenerate 
condition  is  met  with  in  from  2  to  7  children  of  a 
family,  that  the  cause,  whatever  it  may  be,  comes  from 
the  parents,  in  other  words,  is  hereditary.  Here,  then, 
oat  of  3297  cases  we  have  651,  or  20  per  cent.,  in 
which  the  condition  is  proved  to  be  due  to  parental 
defect,  from  the  fact  of  its  attacking  from  2  to  7  of 
the  children  of  those  parents.  It  will  be  noticed  that 
these  figures  closely  agree  with  those  of  Eibot,  who 
found  2  to  5  children  afflicted  with  deaf-mutism  in  the 
families  of  22  per  cent,  of  the  pupils  of  the  London 
Deaf  and  Dumb  Institution. 

How  any  one  with  all  this  evidence  before  him  can 
come  to  the  conclusion  that  deaf-mutism  does  not 
depend  upon  parental  peculiarity,  but  occurs  merely  as 
a  "sport"  or  freak  of  Nature  quite  beyond  explana- 
tion, and  that  its  repetition  in  several  of  the  children 
of  certain  parents  is  but  a  strange  coincidence,  it  is 
difficult  to  imagine. 

We  have  also  evidence  of  congenital  deafness  being 
transmitted  unchanged  through  several  generations. 
"Mr.  Burton,  who  has  paid  great  attention  to  this 
subject,  refers  to  several  families  where  the  deaf- 
mutism  has  been  transmitted  through  three  successive 
generations,  though  in  some  instances  the  affection 


166 


MARRIAGE  AND  DISEASE. 


passes  over  one  generation,  to  reappear  in  the  next. 
He  also  relates  a  case  of  a  family  of  sixteen  persons, 
eight  of  whom  were  born  deaf  and  dumb,  and  one, 
at  least,  of  the  members  of  ^hich  transmitted  the 
affection  to  his  descendants  as  far  as  the  third  genera- 
tion." * 

,  Here  is  the  tree  of  a  family  whose  history  is  vouched 
for  by  the  Lunacy  Commissioners  of  Scotland,  which 
shows  the  transmission  of  deaf-mutism  through  four 
generations : — 


Mute. 

Normal. 

F 

1 
M. 
Mute. 
No  issue. 

it 

Normal. 

Normal. 

4. 

Mute. 

i 

Mute. 

M 

Normal. 

Normal. 

M. 

Mute. 


This  is  a  most  interesting  and  instructive  case. 
Besides  showing  that  deaf-mutism  may  be  transmitted 
directly  from  parent  to  child,  in  spite  of  the  other 
parent  being  normal  so  far  as  this  particular  character 
of  degeneration  is  concerned,  it  also  shows  clearly 
that  in  many  cases  where  deaf-mutism  appears  in  the 
children  of  parents  who  can  both  of  them  hear  and 
speak,  the  defect  in  the  children  is  distinctly  heredi- 
tary. Had  we  had  no  family  history,  it  is  not  to  be 

*  Sir  W.  Turner's  Address  to  Anthropological  Section,  British 
Association,  Newcastle,  1889. 


DEAF-MUTISM.  167 

doubted  that  the  deaf-mutes  occurring  in  the  last  two 
generations  of  this  family  would  have  been  set  down 
to  some  inexplicable  freak  of  Nature.  The  parents 
in  each  case  were  both  of  them  normal,  yet  they 
brought  forth  deaf  and  dumb  children.  A  single 
glance  at  the  family  tree  shows  from  whence  came 
the  imperfection. 

Unfortunately,  in  the  histories  of  such  families  as 
the  above,  we  rarely  know  anything  of  the  in-coming 
so-called  normal  parents  beyond  the  fact  that  they 
can  hear  and  speak.  We  do  not  know  whether  they 
approach  the  normal  type,  or  are  members  of  families 
as  degenerate  as  those  into  which  they  marry.  But 
in  such  cases  as  that  before  us,  in  which  deaf-mutism 
or  other  defect  appears  generation  after  generation  in 
the  children  of  normal  members  of  the  tainted  family, 
we  are  justified  in  assuming  that  the  in-coming  parents 
are  also  tainted  with  degeneration,  and  that  it  is  the 
double  parental  taint  which  ensures  the  reappearance 
of  the  pathological  character.  For  instance,  in  the 
family  under  review  the  deaf-mutism  was  only  suffi- 
ciently potent  in  the  great-grandfather  to  reproduce 
itself  in  one  of  his  two  children,  yet  we  find  it  appear- 
ing in  his  children's  children,  and  in  their  children 
again.  We  have  already  seen  how  readily  reversion 
to  the  normal  takes  place  on  the  individual  bearing 
the  lately  acquired  character  "crossing"  with  the 
normal.  All  through  Nature  this  is  the  rule,  and 
when  we  find  a  character  already  latent  in  the  indi- 
vidual for  want  of  prepotence  reappearing  in  the 


168  MARRIAGE  AND  DISEASE. 

offspring  of  that  individual,  we  are  justified  in  assuming 
that  some  tendency  to  degeneration  in  the  other  parent 
is  the  exciting  cause  of  its  reappearance.  Therefore 
we  must  suspect  the  in-coming  parents  who  joined 
the  above  family  in  its  second  and  third  genera- 
tions of  bearing  some  degenerate  taint ;  for  had  they 
been  free  from  taint,  the  deaf-mutism  would  have 
been  absent  in  the  third,  or  certainly  in  the  fourth 
generation.  The  disease  tendency  in  these  in-coming 
parents  was  not  necessarily  deaf-mutism.  It  may 
have  been  scrofula,  epilepsy,  insanity,  hereditary 
syphilis,  or  any  other  depraved  condition.  All  de- 
generate characters  are  allied,  and  their  promiscuous 
mingling  is  slightly,  if  at  all,  less  dangerous  to 
the  offspring  than  the  intermarriage  of  any  one  of 
them. 

Sir  William  Turner  says: — "There  can  be  little 
doubt  that  congenital  deaf-mutism,  in  the  great 
majority  of  instances,  is  associated  with  a  defective 
development ;  "  *  and  I  think  every  one  who  studies 
the  subject  will  be  of  this  opinion.  Every  person  who 
has  visited  an  Institution  for  the  deaf  and  dumb  must 
have  been  struck  with  the  more  or  less  imbecile  aspect 
of  the  unfortunate  inmates.  In  the  majority  of  deaf- 
mutes,  the  whole  economy,  mental  and  bodily,  is  more 
or  less  blighted.  Many  are  scrofulous,  and  a  vast 
number  succumb  to  phthisis.  Physically  they  are 
poorly  developed ;  they  have  round  backs  and  narrow 

*  Sir  William  Turner's  Address  at  British  Association,  Newcastle, 
1889. 


UNIVERSITY 

OF 


DEAF-MUTISM.  169 

shoulders,  and  their  limbs  are  badly  formed,  while  the 
shape  of  the  head  and  the  cast  of  the  features  point 
strongly  to  a  degenerate  type. 

Physical  deformities,  such  as  large  projecting  ears,* 
slobbering  mouths,  squint,  paralysis,  blindness,  and 
total  idiocy,  are  very  common  among  the  congenital 
deaf,  and  show  the  close  relationship  between  deaf- 
mutism  and  other  forms  of  degeneration.  Professor 
A.  Graham  Bell  of  Washington  has  made  careful 
inquiry  into  this  particular  branch  of  the  question, 
with  the  result  we  might  expect.  He  found  that  the 
ratio  of  blindness  among  deaf-mutes  is  14^  times  as 
great  as  among  the  whole  population;  while  idiocy, 
the  deepest  of  all  forms  of  degeneration,  is  43  times  as 
great  among  these  unfortunates  as  among  the  general 
population. 

This  investigator  (Professor  Bell)  has  recently 
called  attention  to  the  fact  that  between  1870  and 
1880  the  deaf  and  dumb  population  of  the  United 
States  of  America  had  increased  from  10,000  to  34,000. 
This  he  attributed  largely  to  hereditary  transmission, 
and  he  animadverted  severely  upon  the  mistaken  views 
of  would-be  philanthropists,  who,  not  content  with 
mitigating  the  unhappy  lot  of  these  sufferers  by 
educating  them  and  enabling  them  to  do  something 
toward  earning  a  living,  hold  out  inducements  to  them 
to  intermarry.  Unfortunately,  America  is  not  the 

*  Albef  tatti  found  this  character  in  50  per  cent,  of  deaf-mutes. 
It  is  a  commonly  recurring  character  among  idiots  and  instinctive 
criminals.     "  The  Criminal,"  Havelock  Ellis,  p.  So. 
12 


170  MARRIAGE  AND  DISEASE. 

only  country  in  which  such  marriages  are  striven 
after  and  hailed  with  loud  approval.  Too  many  of  the 
lady  patrons  of  our  own  asylums  for  the  crippled  and 
deformed  in  mind  and  body,  from  some  mistaken 
notion  that  even  in  the  case  of  a  dumb  man  or  blind 
woman  a  single  life  must  necessarily  be  incomplete, 
depraved,  and  sinful,  are  only  too  ready  to  encourage 
marriage  among  those  who  themselves  require  the 
assistance  of  others  to  enable  them  to  live.  These 
ladies  should  understand  that  all  such  marriages  are 
outrages  against  Nature's  benign  laws,  and  that  their 
promoters  must  be  suspected  of  the  same  morbid 
feeling  which  fills  a  church  to  witness  the  wedding 
of  a  Tom  Thumb  or  some  monster  from  one  of  Barnum's 
side-shows. 

Professor  Bell  says : — "  Philanthropy  in  this  country 
[America]  is  doing  everything  possible  to  encourage 
marriage  among  deaf-mutes.  .  .  .  Unless  this  system 
of  management  is  changed,  we  shall  certainly  have 
a  deaf  variety  of  the  human  race."  But  of  this  I  can 
see  no  danger.  By  encouraging  these  unhappy  crea- 
tures to  marry  and  inter-marry,  we  certainly  can  in- 
crease the  numbers  of  the  idiotic,  blind,  deaf,  insane, 
scrofulous,  deformed,  and  otherwise  degenerate,  and 
so  increase  vastly  the  already  too  great  amount  of 
human  suffering.  But  few  such  families  will  long 
survive,  and  none  of  them  will  live  in  posterity. 
Were  the  absence  of  the  sense  of  hearing  the  only 
fault  in  the  stock  from  which  our  deaf-mutes  spring, 
there  is  no  reason  why,  under  the  artificial  conditions 


DEAF-MUTISM.  171 

of  civilised  life,  a  deaf  variety  of  mankind  should 
not  be  founded,  as  Sir  William  Lawrence  said  we 
might  found  a  six-fingered  variety.  But  congenital 
deafness  is  not  the  simple  absence  of  one  of  the  senses 
which  is  not  absolutely  necessary  for  life ;  it  is  a  sign 
of  a  general  decay,  which,  if  deepened  by  intermar- 
riage, must  soon  reach  the  necessarily  fatal  type  and 
extinguish  the  family.* 

Congenital  deaf-mutism  may,  and  does,  occur  at 
times  in  families  in  which  it  is  impossible  to  dis- 
cover any  signs  ot  decay  of  the  stock.  But  even 
here  its  appearance  is  generally  to  be  explained. 
In  such  cases,  the  blight  most  frequently  depends 
upon  initial  heredity,  for  the  deaf-mute,  like  the 
idiot,  is  often  the  result  of  drunkenness  on  the 
part  of  the  parent  when  the  child  was  begotten. 
In  these  cases  the  deafness  is  generally  accompanied 
by  considerable  imbecility  or  by  some  physical 
deformity.  Another  common  cause  of  deaf-mutism 
is  habitual  drunkenness  in  the  parent;  but  these 
cases  may  well  be  classed  with  the  great  mass,  for 
it  is  always  to  be  suspected  that  the  habitual 
drunkenness  in  the  parent  is  itself  the  result  of  an 
inherited  taint,  which  is  transmuted  in  passing  to  the 
child. 

Another  cause  of  deaf-mutism  is  syphilis  in  the 
parent.  This  disease,  as  we  have  seen,  often  brings 

*  Menckel  has  published  cases  showing  how  frequently  the 
children  of  deaf-mutes  exhibit  imbecility,  i.e.,  a  stage  further  on 
the  downward  course. 


172  MARRIAGE  AND  DISEASE. 

about  an  impoverished,  devitalised  condition  of  the 
system,  which  is  reproduced  in  the  offspring  as  idiocy, 
scrofula,  epilepsy,  deaf-mutism,  or  some  such  blight. 

Seeing,  then,  that  this  terrible  affliction  is  rarely, 
as  some  would  have  us  believe,  an  inexplicable  freak 
of  Nature,  but  in  most  cases  has  its  origin  in  some 
parental  character  more  or  less  degenerate,  it  behoves 
us  to  consider  seriously  the  advisability  of  the  marriage 
of  those  so  afflicted,  and  of  their  kindred. 

Firstly,  it  should  be  impressed  upon  all,  and  espe- 
cially upon  a  certain  class  of  philanthropist,  that  the 
congenital  deaf  should  not  be  induced,  or  even  per- 
mitted, to  intermarry.  The  vis  medicatrix  naturae 
should  here,  as  elsewhere,  be  given  a  chance  of  im- 
proving the  family  stock,  and  this  cannot  be  where 
both  parents  are  tainted. 

In  the  next  place,  it  is  doubtful  whether  deaf-mutes 
should  marry  at  all.  However,  if  a  deaf-mute  can  in- 
duce some  normal  person  of  the  opposite  sex  to  take 
him  for  better  for  worse — and  such  a  union  should 
have  its  advantages — we  could  hardly  expect  him  to 
say  "No"  in  the  interests  of  those  still  unborn.  But 
whether  any  person  of  reasonably  sound  development 
could  be  induced  to  enter  into  such  a  union  is  ex- 
tremely problematical,  and  in  this  fact  lies  the  danger. 
If  the  perfectly  sound  could  be  mated  with  the  deaf- 
mute,  there  can  be  little  doubt  that  in  many  cases 
the  degenerate  character  would  be  lost  by  the  rever- 
sion of  the  children  to  the  normal  type.  But  in  few 
instances  will  the  sound  and  healthy  be  fascinated  by 


DEAF-MUTISM.  173 

such  unfinished  creatures  as  the  deaf-mute,  "the  poor 
creatures  .  .  .  are  specimens  of  Nature's  workmanship 
in  its  most  untidy  mood;  features  have  rarely  been 
duly  chiselled ;  the  sense  of  beauty  has  long  been 
dead,  while  gawhe  figures  and  manners  often  render 
the  victims  little  short  of  repulsive  to  all  but  those 
who,  born  under  like  conditions,  have  their  faculties 
of  perception  so  maimed  and  blunted  that  they  know 
no  better,  and  are  also  debarred  from  making  any 
higher  choice."  *  Thus,  the  deaf-mute  is  thrown  back 
from  the  society  of  the  more  normal  to  that  of  his  own 
grade  of  development,  and  reversion  in  his  children 
is  denied  an  opportunity. 

As  to  marriage  with  the  near  relatives  of  the  deaf- 
mute,  the  wise  man  or  woman  will  think  twice,  or 
even  thrice,  before  entering  into  such  an  alliance.  Just 
as  the  idiot  or  epileptic  child  in  a  family  points  to 
a  family  tendency  to  degeneration  which  may  take 
on  some  other  form  in  the  next  generation,  so  the 
family  in  which  the  deaf-mute  has  appeared  is  to  be 
looked  upon  with  grave  suspicion,  or,  better  still, 
avoided  altogether.  The  man  or  woman  who  espouses 
the  brother  or  sister  of  the  deaf-mute  must  not  be 
surprised  if  blindness,  idiocy,  or  some  other  terrible 
imperfection,  appear  in  some  of  the  children. 

Fortunately,  it  is  not  necessary  to  put  a  premium  upon 
the  procreation  of  children  in  this  country.  Accord- 
ing to  some  economists,  our  population  increases  almost 

*  J.  Kussell  Keynolds,  M.D.,  F.R.S.,  address  before  Congress  of 
the  Sanitary  Institute  of  Great  Britain,  1887. 


174  MARRIAGE  AND  DISEASE. 

too  rapidly  as  it  is.  Why,  then,  should  the  deformed 
and  unfinished  be  tempted  to  add  to  the  struggling 
throng  creatures  who  must  sink  by  the  wayside  in 
the  fierce  struggle  for  existence  ?  Rather  let  them 
be  taught  the  beauty  of  self-denial,  and  be  induced 
to  refrain  from  entailing  upon  others  the  afflictions 
which  have  fallen  upon  themselves  from  no  fault  of 
their  own. 


CHAPTER  XIII. 

CANCER. 

"  The  more  I  have  seen  of  cancer  as  occurring  among  families 
where  the  family  history  is  known,  the  greater  becomes  the  number 
of  cases  in  which  well-marked  inheritance  can  be  traced.  .  .  .  Now 
I  can  without  difficulty  count  as  actual  facts  not  less  than  one  in 
three  of  the  patients  with  cancer  in  whose  families  the  occurrence 
of  cancer  is  well  known." — SIR  JAMES  PAGET.* 

"  We  cannot  over-estimate  the  importance  of  inheritance  in  the 
origination  of  cancer." — SIR  WILLIAM  AiTKEN.t 

CANCER  is  at  once  the  most  painful,  revolting,  and 
fatal  of  diseases.  It  spares  neither  age  nor  sex,  neither 
rich  nor  poor.  The  emperor  in  his  palace  and  the 
pauper  in  his  crib  are  equally  within  its  reach.  Once 
it  has  marked  a  person  for  its  own,  it  clings  relent- 
lessly to  its  victim  until  the  grave  closes  over  him ;  and 
on  the  journey  thither,  which  is  sometimes  long,  it  too 
often  racks  him  with  excruciating  pain,  and  renders  him 
fruch  a  pitiable  and  loathsome  object,  that  his  friends  pray 
in  secret  for  his  emancipation  at  the  hand  of  death. 

Cancer  is  a  disease  for  which  there  is  no  cure  known. 
The  knife  of  the  surgeon  is  our  only  hope.  In  cases 
judiciously  chosen,  early  extirpation,  where  that  is 

*  Pathological  Soc.  Trans.,  1874,  vol.  xxv,  p.  317. 
t  Op.  tit. 


I ;6  MARRIAGE  AND  DISEASE. 

possible,  may  give  prolonged  relief;  indeed,  death 
may  occur  from  some  other  cause  before  the  cancer 
returns.  But  in  the  vast  majority  of  cases  it  does 
return — in  some  cases  very  rapidly,  and  seemingly  with 
increased  virulence — and  it  is  generally  thought  that 
if  life  were  sufficiently  prolonged  it  would  reappear 
in  all  cases.  Sir  James  Paget  records  a  case  which 
shows  how  much  and  how  little  the  surgeon  can  do 
against  the  disease.  It  was  the  case  of  a  lady  "  whose 
breast  he  removed  when  she  was  five  months  advanced 
in  pregnancy.  She  recovered  well  from  the  operation, 
and  the  benefit  procured  by  its  performance  was  very 
great.  She  bore  her  child,  and  was  able  to  suckle  it 
for  a  year  before  she  died,  with  her  most  anxious  wish 
fulfilled,  in  comparative  comfort."  What  a  prospect 
for  the  unfortunate  child  ! 

Of  these  malignant  growths  there  are  several 
varieties:  the  hard,  called  scirrhus,  which  generally 
attacks  persons  in  the  decline  of  life,  and  is  rarely 
seen  in  persons  under  forty  years  of  age ;  the  soft  or 
medullary,  which  is  of  more  rapid  growth,  and  conse- 
quently more  rapidly  fatal,  and  which  in  most  cases 
attacks  the  young  and  those  in  the  prime  of  life;  the 
epithelial,  which  is  almost  always  found  in  connection 
with  the  skin  or  a  mucous  surface ;  the  melanotic, 
which  is  so  called  from  the  strange  fact  that  many 
of  its  cells  are  so  loaded  with  pigment  granules  as 
to  render  the  tissue  quite  dark  in  colour;  and  the 
osteoid,  in  which  the  malignant  growth  is  made  np 
almost  wholly  of  bone.  All  these  forms  differ  more 


CANCER.  177 

or  less  as  to  mode  of  onset,  rapidity  of  growth,  period 
of  life  at  which  -they  appear,  and  tissue  or  organ 
forming  their  favourite  seat  of  attack ;  but  all  have 
one  character  in  common,  and  that  is,  once  established 
they  never  relinquish  their  victim. 

Considering  that  this  terrible  disease  has  been 
increasing  of  late  at  an  alarming  rate,  it  is  of  the 
utmost  importance  that  people  should  have  some  idea 
of  the  conditions  which  appear  to  give  rise  to  it,  more 
especially  if  by  the  dissemination  of  such  knowledge 
it  be  deemed  possible  to  limit,  in  however  small  a 
degree,  its  ravages  in  society. 

It  is  several  years  now  since  it  was  first  whispered 
that  cancer  was  on  the  increase.  This  uncomfortable 
suspicion  gradually  spread,  and  soon  infected  the 
general  public  and  the  medical  profession  alike.  Proof 
was  added  to  proof,  and  what  was  but  a  suspicion 
soon  became  an  established  fact.  It  became  evident 
to  all  that  this  cruel  scourge  of  mankind  was  increas- 
ing among  the  inhabitants  of  this  and  other  civilised 
countries.  The  number  of  deaths  attributed  to  this 
disease  in  the  Registrar-General's  returns  grew  steadily 
— grew  out  of  all  proportion  to  the  increase  of  popula- 
tion; but  being  a  disagreeable  subject,  it  was,  like 
other  disagreeable  matters,  allowed  to  lie  in  the  back- 
ground for  a  time.  This,  however,  as  we  might  expect, 
had  no  effect  upon  the  figures  of  the  Registrar-General, 
and,  as  these  went  on  increasing  annually,  it  at  length 
became  necessary  to  attack  the  distasteful  subject. 

As  is  usual  in  all  cases  where  the  desire  to  prove 


1 78  MARRIAGE  AND  DISEASE. 

a  negative  is  strong,  an  attempt  was  made  to  explain 
away  the  growing  figures  of  the  Registrar-General. 
This,  unfortunately,  was  found  impossible.  Then  it 
was  argued,  on  the  one  hand,  that  there  had  always 
been  the  present  amount  of  cancer  among  the  people, 
but  that,  from  want  of  care  and  knowledge,  it  had 
not.  been  recognised  and  registered  as  such ;  while 
some,  on  the  other  hand,  asserted  that  the  recent 
advance  of  scientific  knowledge  in  medicine  had  so 
excited  the  judgment  of  the  younger  among  medical 
men,  that,  in  an  over-anxiety  to  display  their  critical 
discrimination  of  abnormal  tissues,  they  had  been 
induced  to  believe  malignant  what  were  in  reality 
benign  growths.  These  arguments  answered  each 
other,  and  as  no  theory  was  found  sufficient  to  combat 
the  Registrar-General's  hard  facts,  it  was  eventually  ad- 
mitted that,  from  whatever  cause,  this  terrible  disease 
was  really  increasing  in  every  grade  of  society.  The  in- 
crease was  perhaps  most  marked  among  the  inhabitants 
of  our  great  centres  of  population,  but  that  there  was  an 
increase,  that  it  was  growing  steadily,  and  that  it  was 
general,  was  at  length  reluctantly  admitted. 

Sir  Spencer  Wells,  in  his  Morton  Lectures  delivered 
before  the  Royal  College  of  Surgeons  of  England  in 
November  1888,  was  unable  to  bring  forward  any 
explanation  of  the  increase  in  the  death-rate  from 
cancer  satisfactory  to  himself,  and  openly  acknowledged 
his  acceptance  of  the  belief  that  cancer  was  rapidly 
increasing  among  our  people.  In  his  very  excellent 
lectures  Sir  Spencer  brought  forward  a  more  elaborate 


CANCER.  179 

and  carefully  prepared  array  of  figures  than  had  ever 
before  been  presented  on  the  subject,  and  the  whole 
drift  of  his  statistics  was  to  confirm  the  generally 
accepted  belief  that  the  disease  was  increasing  in  pre- 
valence, not  only  among  the  inhabitants  of  England 
and  Wales,  but  also  among  those  of  Scotland,  Ireland, 
and  the  United  States  of  America ;  in  fact,  among  all 
civilised  peoples  from  whom  statistics  on  the  subject 
were  obtainable. 

The  number  of  deaths  from  cancer  in  England  and 
Wales  increased  from  7245  in  1861  to  18,654  in  1889; 
but  as  the  population  increased  largely  during  this 
period,  these  figures  do  not  give  a  correct  idea  of  the 
prevalence  of  the  disease  in  proportion  to  the  popula- 
tion. The  Kegistrar-General,  however,  supplies  figures 
which  do  convey  a  correct  idea  of  the  prevalence  of 
the  disease;  they  are  these: — In  1861  the  number  of 
deaths  from  cancer  to  one  million  persons  living  was 
360,  which  number  had  in  1888  reached  610  by  an 
increase  of  marvellous  regularity.  Of  this  increase  Sir 
Spencer  Wells  says : — "  I  think  it  hardly  possible  that 
this  steady  increase  in  twenty-six  years  from  360  to 
610  deaths  from  cancer  among  each  million  persons  in 
England  and  Wales  during  that  period  can  be  truly 
attributed  to  any  great  extent  to  better  registration ; " 
and  with  this  I  think  all  must  agree. 

Nor,  as  I  have  already  hinted,  is  this  alarming  state 
of  things  confined  to  England  and  Wales.  In  Scotland 
deaths  from  cancer  are  at  present  even  more  plentiful 
in  proportion  to  the  population  than  in  England ;  while 


i8o  MARRIAGE  AND  DISEASE. 

Ireland,  though  considerably  less  afflicted  with  the 
disease  than  other  parts  of  the  kingdom,  also  shows  a 
steady  increase  during  the  past  ten  years.  According 
to  Dr.  Fordyce  Barker,  the  condition  of  affairs  is 
almost  the  same  in  America  as  with  us  in  the  United 
Kingdom.  The  mortality  from  cancer  had  increased 
in  New  York  from  400  to  the  million  in  1875  to  530 
to  the  million  in  1885.  In  commenting  upon  this  fact 
Dr.  Barker  remarks,  that  the  disease  is  much  less 
frequent  among  the  negroes  than  the  whites,  and  that 
the  mortality  from  cancerous  disease  is  largest  "in 
those  nations  which  are  the  most  advanced  in  civilisa- 
tion," or,  in  other  words,  in  those  peoples  who  interfere 
most  with  the  laws  which  govern  natural  life. 

And  now  as  to  the  cause  of  this  disease  and  of  its 
increase  among  civilised  nations.  As  to  the  origin  of 
the  disease,  I  may  say  at  once  nothing  is  known. 
Cancer  has  been  known  and  feared  from  very  early 
times,  and  various  theories  as  to  its  cause  have  been 
advanced  from  time  to  time,  but  none  has  met  with 
anything  like  general  acceptance.  Recently  the  vege- 
tarian faddists  have  advanced  and  strongly  maintained 
the  theory  that  cancer  is  the  result  of  a  diet  too  largely 
composed  of  animal  food  ;  but  this  theory  has  nothing 
whatever  to  support  it,  and  is  at  once  disposed  of  by 
the  fact  that  the  death-rate  from  cancer  is  actually 
higher  in  Scotland,  where  the  diet  of  the  majority  is 
very  largely  vegetable,  than  in  England,  where  it  is 
as  largely  animal.  If  this  theory  were  true,  the  dis- 
ease would  have  been  rife  among  such  peoples  as  the 


CANCER.  181 

American  Indians,  who  lived  almost  wholly  upon  the 
spoils  of  the  chase,  whereas  we  know  that  such  was  not 
the  case. 

For  my  part,  I  may  say  I  look  upon  cancer  as  the 
outward  sign  of  a  constitutional  degeneration,  brought 
about,  like  every  other  degeneration,  by  interference 
with  the  laws  of  natural  life,  and  very  closely  related 
to  those  other  degenerate  states  which  have  for  their 
outward  signs  such  diseased  conditions  as  epilepsy, 
habitual  drunkenness,  insanity,  suicide,  and  scrofula. 
That  this  is  so  is,  I  think,  proved  by  the  manner  in 
which  it  increases  with  what  we  are  pleased  to  call 
civilisation,  that  is,  where  the  interference  with  the 
laws  of  Nature  is  most  marked,  and  the  vitality  of  the 
stock  most  reduced  in  consequence ;  by  the  fact  that 
it  is,  like  every  other  degeneration,  transmitted  heredi- 
tarily— of  which  we  shall  have  ample  proof  later  on ; 
and  by  the  still  stranger  fact  that  cancer  may  be,  and 
frequently  is,  transmuted  in  transmission  to  scrofula, 
suicide,  epilepsy,  and  insanity. 

The  cancerous  diathesis,  then,  is  a  peculiarity  of 
constitution,  depending  upon  degeneration,  which  pre- 
disposes the  owner  to  malignant  growths  of  lowly 
organised  tissue  called  cancer,  and  which  is  trans- 
mitted to  his  offspring,  where  the  outward  sign  of 
the  lack  of  vitality  may  differ  widely  from  that  in 
the  parent. 

In  this  predisposition  we  have  the  real  cause  of 
cancer  in  the  individual.  How  this  predisposition 
was  originally  built  up  we  cannot  at  present  tell,  but 


1 82  MARRIAGE  AND  DISEASE. 

doubtless  many  elements  of  unhealth  combined  in  its 
evolution. 

Latterly  the  opinion  has  been  expressed  by  some 
that  cancer  probably  depends  upon  some  micro- 
organism, and  this,  I  believe,  will  ultimately  prove  to 
be  true.  In  1887,  Scheuerlen,  of  Berlin,  announced 
that  he  had  discovered  a  bacillus  peculiar  to  cancerous 
growths ;  but  closer  investigation  proved  fatal  to  the 
discovery.  Professor  Virchow  found  the  same  micro- 
organism growing  upon  sections  of  'potato  which  could 
not  have  been  contaminated  from  any  cancerous  tissue. 
Nevertheless,  this  appears  to  be  the  most  promising 
direction  for  investigation,  and  it  is  not  at  all  impro- 
bable that  ere  long  cancer  may  be  found  to  depend 
upon  the  presence  of  some  micro-organism;  which 
discovery,  when  made,  will  in  no  way  aifect  the  theory 
of  the  hereditary  character  of  the  disease. 

Predisposition  must  exist  in  nearly  every  case  in 
which  cancer  occurs.  It  is  by  no  means  unusual  for 
cancer  to  follow  local  injuries  to  tissues  or  organs. 
A  blow  upon  the  breast  will  often  be  found  the  start- 
ing-point of  a  cancer  in  woman,  and  the  irritation 
caused  to  the  lips  by  the  continued  use  of  a  clay  pipe, 
or  to  the  tongue  by  decayed  teeth,  is  frequently  given 
as  the  cause  of  the  disease.  But  such  injury  or  irri- 
tation can  only  be  the  exciting  cause,  else  thousands 
more  than  are  at  present  would  be  the  victims  of 
cancer.  How  many  thousands  receive  injuries  to  the 
breast,  smoke  clay  pipes,  and  have  their  tongues  irri- 
tated by  broken  teeth  without  result?  Those  who 


CANCER.  183 

from  such  causes  get  cancer  are  predisposed  to  it 
constitutionally.  On  this  point  Professor  von  Esmarch 
says : — "  One  has  always  to  come  back  to  the  assump- 
tion that  a  certain  predisposition  is  a  necessary  factor. 
Without  this  it  is  impossible  to  explain  how  it  is  that, 
in  the  great  majority  of  cases  in  which  irritation  exists, 
cancer  does  not  become  developed." 

Without  this  hereditary  predisposition  not  even 
inoculation  will  convey  the  disease.  Alibert  and  other 
investigators  inoculated  themselves  with  cancerous 
matter,  and  Harley  and  Lawrence  performed  the  same 
operation  upon  dogs,  without  effect ;  which  clearly 
shows  that  if  there  be  no  predisposition,  if  the  soil 
be  not  by  nature  suitable,  even  the  introduction  of 
the  bacillus — if  there  be  a  bacillus — or  of  the  poison 
into  the  system  will  fail  to  establish  the  disease.  Just 
as  some  are  born  with  a  predisposition  to  consumption, 
and  fall  victims  to  the  disease  under  conditions  harm- 
less to  those  not  so  predisposed,  so  others  are  born 
with  a  predisposition  to  cancer,  and  in  these  the  malig- 
nant disease  lights  up  from  injury  or  irritation,  which 
the  healthy  undergo  with  impunity. 

On  the  ground,  then,  that  predisposition  accounts 
for  the  appearance  of  cancer  in  the  individual,  the 
alarming  increase  of  the  disease  among  the  population 
is  to  be  attributed  to  propagation  and  cultivation  of 
this  predisposition.  In  the  spread  of  this  family  pre- 
disposition there  are  two  agencies  at  work.  First, 
and  by  far  the  most  powerful,  is  hereditary  transmis- 
sion; for  just  as  epilepsy,  suicide,  and  drunkenness  are 


1 84  MARRIAGE  AND  DISEASE. 

in  certain  families  handed  down  from  generation  to 
generation,  so  in  other  families  is  that  degenerate  con- 
stitutional state,  whose  most  frequent  outward  sign  is 
cancerous  disease,  regularly  transmitted.  The  second 
agency  at  work  in  the  production  of  the  predisposition 
to  cancer  is  made  up  of  all  the  degenerating  influences 
of  modern  civilised  life,  which  are  constantly  deterio- 
rating the  race,  and  deepening  this  and  every  other 
pathological  character. 

That  cancer  is  a  disease  which  points  to  degenera- 
tion of  the  stock  in  which  it  appears  is  clear  from 
the  close  relationship  which  exists  between  it  and  other 
admittedly  degenerate  conditions,  such  as  scrofula, 
suicide,  and  insanity.  Sir  William  Gull*  years  ago 
pointed  out  that  scrofulous  children  were  very  fre- 
quently the  offspring  of  parents  who  had  cancer, 
or  were  members  of  families  in  which  cancer  was 
common.  On  the  other  hand,  the  frequency  with 
which  cancer  attacks  members  of  families  showing 
the  epileptic,  suicidal,  or  insane  diathesis  is  notorious. 
Again,  just  as  we  have  seen  that  a  commingling  or 
combination  of  the  taints  of  insanity  and  epilepsy, 
or  epilepsy  and  drunkenness,  &c.,  tends  to  further 
degenerate  the  offspring  to  impotent  idiocy  —  the 
lowest  stage  of  degeneration  compatible  with  a  con- 
tinuance of  life — so  we  find  a  combination  of  this 
degenerate  condition  which  predisposes  to  cancer  with 
another  form  of  degeneracy  will  produce  offspring 
lower  in  the  scale  than  either  parent.  Of  this  a  very 
*  Address  before  British  Medical  Association,  Oxford,  1883. 


CANCER.  185 

good  example  is  given  by  Dr.  B.  Ward  Kichardson, 
who  says : — "  The  intermarriage  of  cancer  and  con- 
sumption is  a  combination  specially  fraught  with 
danger."  He  gives  the  following  case: — "A  young 
man  of  marked  cancerous  proclivity  married  a  woman 
whose  parents  had  both  died  of  pulmonary  con- 
sumption. This  married  couple  had  a  family  of  five 
children,  all  of  whom  grew  up  to  adolescence,  sustain- 
ing at  their  best  but  delicate  and  feeble  existences. 
The  first  of  these  children  died  of  a  disease  allied  to 
cancer,  called  lupus ;  the  second,  of  simple  pulmonary 
consumption;  the  third,  owing  to  tubercular  deposit 
in  the  brain,  succumbed  from  epileptiform  convul- 
sions ;  the  fourth,  with  symptoms  of  tubercular  brain 
disease,  sank  from  diabetes,  the  result  of  the  nervous 
injury;  and  the  last,  living  longer  than  any  of  the 
rest,  viz.,  to  thirty-six  years,  died  of  cancer.  The 
parents  in  this  instance  survived  three  of  the  children, 
but  they  both  died  comparatively  early  in  life — the 
father  from  cancerous  disease  of  the  liver,  the  mother 
from  heart  disease  and  bronchitis."  *  In  this  case 
there  was  no  chance  of  reversion  to  the  healthy  type, 
and  the  result  was  the  same  as  in  several  of  the 
families  already  mentioned  in  the  chapters  on  insanity 
and  epilepsy  where  both  parents  were  tainted,  viz., 
extinction  of  the  family.  Only  one  of  these  wretched 
children  lived  to  die  of  cancer;  but  it  cannot  be 
doubted  that  had  the  others  survived  longer,  more 
of  them  would  have  developed  malignant  disease. 

*  "  Diseases  of  Modern  Life." 
13 


1 86  MARRIAGE  AND  DISEASE. 

As  it  was,  four  of  them  had  not  sufficient  vitality  to 
enable  them  to  hold  on  to  life  until  that  age  at  which 
cancer  most  commonly  appears,  and  they  succumbed 
one  after  another  to  tubercular  disease,  the  scourge 
of  those  bankrupt  in  vitality. 

Now,  in  the  first  place,  this  "  young  man  of  marked 
cancerous  proclivity  "  should  never  have  married,  and 
it  is  possible  that  had  he  been  convinced  as  to  what 
would  be  the  outcome  of  his  marriage  he  would  have 
foregone  the  pleasures  of  matrimony.  But  if  he  would 
marry,  then  he  should  have  chosen  a  partner  free, 
so  far  as  possible,  from  degeneration.  Had  he  done 
so,  it  is  possible  some  of  the  children  might  have 
escaped;  but  as  it  was,  the  offspring  had  no  chance 
of  coming  back  to  the  path  of  health,  and  Nature 
stamped  them  out  as  unfit. 

The  family  history  which  I  gave  at  page  49  shows 
very  clearly  the  close  kinship  existing  between  the 
cancerous  diathesis  and  those  other  forms  of  consti- 
tutional degeneration  whose  outward  symptoms  are 
infantile  convulsions,  suicide,  epilepsy,  insanity,  tuber- 
cular disease,  and  sterility.  The  father  of  this  family 
died  of  cancer  of  the  stomach  at  sixty-six  years  of 
age.  He  had  a  brother  who  cut  his  throat  at  fifty- 
six;  the  mother,  an  apparently  healthy  woman,  "died 
of  a  fit "  at  the  age  of  fifty-four.  To  this  pair  seven 
children  were  born,  as  follows: — I.  A  son  who  died 
of  cancer  of  the  stomach  at  fifty-eight.  2.  A  son 
who  died  in  convulsions,  aged  thirteen  weeks.  3, 
4,  and  5.  Three  daughters  who  died  of  consumption, 


CANCER.  187 

one  at  the  age  of  sixteen,  the  other  two  later  in  life, 
and  after  being  married  for  many  years ;  neither  left 
any  issue.  6.  A  son  who  is  epileptic,  and  has  twice 
been  confined  in  lunatic  asylums ;  married — no  issue ; 
and  7.  A  son  who  is  up  till  now  sane,  and  enjoying 
fair  health. 

Here  the  taint  in  the  mother  appears  to  have  been 
slight,  still  it  was  there,  and  while  certainly  preventing 
reversion,  it  doubtless  deepened  the  degeneration  of 
the  father  in  the  children.  In  the  father's  stock  the 
taint  was  much  deeper,  and  it  is  to  be  noticed  that 
while  it  was  exhibited  as  cancer  in  him,  it  took  the 
form  of  suicidal  impulse  in  his  brother.  In  the 
children  of  this  pair  we  have  the  disease  of  the 
father  transmitted  to  the  eldest  son,  but  will  any 
one  refuse  to  believe  that  the  infantile  convulsions, 
the  liability  to  tubercular  disease,  the  epilepsy,  the 
insanity,  and  the  marked  sterility,  were  but  the  vary- 
ing symptoms  of  the  degenerate  nature,  inherited 
from  a  father  who  might  have  died  of  some  acute 
disease  at  any  age  under  sixty-six,  taking  the  secret 
of  his  nature  with  him,  and  leaving  the  origin  of  his 
children's  unfitness  a  mystery. 

Another  and  a  very  strong  proof  that  the  cancerous 
diathesis  is  a  family  degeneration  is  to  be  found  in 
the  fact  that,  when  deeply  marked,  it  is  not  unfre- 
quently  accompanied  by  sterility,  just  as  are  the 
lower  grades  of  the  scrofulous,  insane,  and  other 
degenerate  temperaments.  On  this  ground  would  I 
account  for  the  fact  that  cancer  so  frequently  attacks 


1 88  MARRIAGE  AND  DISEASE. 

the  childless  woman.  The  frequency  with  which 
malignant  disease  attacks  the  womb,  breast,  and  other 
organs  in  this  class  is  generally  set  down  as  the 
result  of  an  abnormal  state  of  those  organs,  because 
of  their  never  having  been  called  upon  to  perform 
the  functions  for  which  they  were  designed;  but  I 
would  argue  that  the  degenerate  state  of  the  system, 
which  ultimately  shows  itself  in  cancerous  growth, 
brought  about  the  barrenness,  rather  than  that  the 
absence  of  physiological  activity  was  the  cause  of  the 
disease.  In  support  of  this  theory,  which  I  believe 
has  never  before  been  advanced,  I  would  point  out 
that  a  large  number  of  the  children  of  cancerous 
parents,  who  themselves  may  never  develop  cancer, 
are  childless.  We  have  an  example  of  this  in  the 
family  whose  history  I  have  just  given,  in  which  no 
less  than  two  married  daughters  and  one  married 
son  were  childless.  Further,  I  would  point  out  that 
cancer  does  not  attack  the  unmarried  woman,  in 
whom  the  functions  of  the  generative  organs  are  in 
total  abeyance,  to  anything  like  the  same  extent 
that  it  does  the  barren  married  woman,  in  whom  the 
organs  are  submitted  in  a  great  degree  to  the  nervous 
excitement  necessary  for  their  functional  health.  The 
children  of  the  cancerous  are  undoubtedly  deficient  in 
vitality,  and  the  deficiency  may  make  itself  evident 
in  barrenness,  as  it  may  in  idiocy,  or  scrofula,  or 
epilepsy,  or  insanity.  In  my  opinion  the  barren 
woman  who  develops  cancer,  or  who  is  the  daughter 
of  a  markedly  cancerous  stock,  is  barren  from  the 


CANCER.  189 

• 

same  cause  that  the  female  imbecile  and  the  prostitute 
are  barren,  viz.,  because  she  has  reached  a  state  of 
degeneracy  at  which  Nature  refuses  to  continue  the 
race. 

Unfortunately  cancer  is  one  of  those  diseases  which 
in  the  vast  majority  of  cases  does  not  make  itself 
known  until  late  in  life,  and  many  who  bear  within 
them,  and  convey  to  their  children,  the  tendency  to 
this  disease,  die  of  some  other  affection,  without  ever 
becoming  aware  of  the  curse  they  have  borne  about 
with  them  through  life,  and  handed  on  to  their 
children.  To  this  fact  is  to  be  attributed  those 
numerous  cases  where  we  find  several  children,  of 
parents  who  have  died  without  displaying  a  sign  of 
cancer,  dying  one  after  another  of  malignant  disease. 
On  this  subject  Sir  James  Paget  remarks : — "  Now  I 
can  without  difficulty  count  as  actual  facts  not  less 
than  one  in  three  of  the  patients  with  cancer  in  whose 
families  the  occurrence  of  cancer  is  well  known.  But 
this  number  does  not  nearly  represent  what  we  may 
very  safely  assume  to  be  the  predominance  of  inheri- 
tance of  cancer.  A  large  number  of  persons  die  of 
internal  cancer,  and  convey  it  to  their  offspring, 
though  it  is  never  known  that  they  themselves  have 
been  the  subjects  of  cancer,  or,  at  least,  is  never 
recorded.  A  large  number  more  die  before  they  have 
manifested  the  cancerous  disposition  which  is  in  them- 
selves ;  for,  paradoxical  as  it  may  seem,  if  a  man  have 
not  outlived  the  utmost  age  of  man,  we  are  bound 
not  to  believe  that  he  might  not  have  been  the 


IQO  MARRIAGE  AND  DISEASE. 

subject  of  cancer;  for  cancer  is  eminently  a  disease 
of  degeneracy,  a  disease  of  which  the  frequency  in- 
creases as  years  increase — i.e.,  in  proportion  to  the 
number  of  persons  living  at  each  period  of  life,  the 
number  of  cancer  cases  increases  as  age  increases.  So 
that  unless  a  man  have  lived  to  the  full  age  of  life, 
he  may  have  died  of  some  other  disease  than  cancer, 
and  never  have  manifested  the  cancerous  tendency 
which  he  yet  conveys  in  predisposition  to  his  offspring. 
The  cases  are  very  far  from  rare  in  which  offspring 
die  of  cancer  long  before  their  parents.  The  parent 
lives,  and  maintains  that  cancer  was  never  known  in 
the  family,  but  a  few  years  elapse,  and  then  the 
parent  dies  of  the  very  same  disease  as  the  offspring 
died  of,  having  been  quite  ignorant  of  the  convey- 
ance of  the  disease  of  which  the  offspring  died."  * 

But  it  is  not  necessary  to  labour  the  point.  That 
cancer  is  eminently  an  hereditary  disease  is  admitted 
by  all  the  greatest  authorities  in  the  medical  world; 
and  that  being  admitted,  it  is  impossible  to  deny 
that  hereditary  transmission  must  be  responsible  for 
a  large  proportion  of  the  alarming  increase  which 
has  taken  place  in  recent  years.  In  almost  every 
case  which  occurs,  if  we  can  only  trace  back  through 
three  or  four  generations,  we  are  sure  to  discover 
the  taint.  Like  every  other  degeneration,  tempera- 
ment, or  diathesis,  it  is  the  work  of  some  consider- 
able time  to  acquire  the  cancerous  diathesis,  and  I  do 
not  believe  it  is  ever  acquired  during  one  lifetime. 
*  Trans.  Path.  Soc.,  voL  xxv.  1874. 


CANCER.  191 

Certainly  our  present  artificial  mode  of  life  saps  the 
vitality  of  the  race  very  rapidly,  and  the  more  it  be- 
comes estranged  from  natural  life,  the  more  rapidly 
will  degenerations  be  acquired,  but  that,  at  the 
present  day,  liability  to  cancer  can  be  built  up  in 
healthy  stock  in  one  generation,  we  have  no  proof 
whatever. 

The  last  two  cases  of  cancer  I  had  under  my  care 
were  women  (who  are  much  more  liable  to  the  disease 
than  men).  One  was  an  imbecile,  a  poor  creature 
with  squint,  and  evidently  of  a  degenerate  stock. 
At  first  no  history  could;  be  got,  but  when  she  was 
dying  a  relative  came  to  visit  her,  and  on  being  told 
the  state  of  affairs,  said,  "  Ah,  poor  soul !  her  mother 
died  of  just  the  same  thing."  The  other  was  a  single 
woman,  of  about  forty-four  years  of  age,  several  of 
whose  brothers  and  sisters  had  died  of  consumption. 
This  was  the  only  family  history  which  could  at  first 
be  got,  but  later  it  was  discovered  that  her  mother 
and  mother's  mother  had  died  of  cancer  of  the  womb. 
These  cases  I  only  mention  as  being  the  last  I  have 
seen ;  taken  alone,  they  would  prove  little.  It  is 
quite  possible  that  the  occurrence  of  the  same  disease 
in  mothers  and  daughters  and  grand-daughter  was 
mere  coincidence ;  such,  however,  could  hardly  be 
the  explanation  of  the  following  case,  which  I  quote 
from  Sir  James  Paget.  A  lady  died  of  cancer  of 
the  stomach ;  of  her  children,  one  daughter  died  of 
cancer  of  the  stomach,  and  another  of  cancer  of  the 
breast.  Of  her  grandchildren,  two  died  of  cancer  of 


192  MARRIAGE  AND  DISEASE. 

the  breast,  two  of  cancer  of  the  uterus,  one  of  cancer 
of  the  bladder,  one  of  cancer  of  the  axillary  glands, 
one  of  cancer  of  the  stomach,  and  one  of  cancer  of 
the  rectum.  It  is  to  be  hoped  that  this  was  the  last 
of  this  wretched  family. 

Such  cases  as  the  above,  where  the  disease  is  trans- 
mitted unchanged  through  several  generations,  are 
comparatively  rare,  yet  these  are  the  only  cases  which 
are  at  present  counted  as  hereditary.  When  the 
transmutability  of  cancer  with  other  signs  of  de- 
generation of  the  family  comes  to  be  more  clearly 
understood,  I  have  no  do:Jbt  that  in  almost  every 
case  we  shall  be  able  to  trace  the  family  taint,  and 
raise  the  percentage  of  cases  depending  upon  heredity 
to  close  upon  100  per  cent. 

And  now,  in  conclusion,  supposing  the  theory  of 
the  hereditary  nature  of  cancer  fully  accepted,  what 
lessons  are  to  be  drawn  from  our  teaching?  In  the 
first  place,  it  behoves  all  those  who  are  aware  of 
cancer  in  ancestor,  or  other  near  blood  relative,  to 
avoid  everything  which  might  act  as  an  exciting 
cause  of  the  disease.  They  must  endeavour  to  keep 
their  health  at  as  high  a  level  as  possible,  by  obeying 
all  the  hygienic  laws  laid  down  for  general  observ- 
ance. They  must  beware  of  irritations  and  injuries 
likely  to  light  up  the  sleeping  predisposition  within 
them.  It  would  be  as  wise  for  the  son  or  daughter 
of  a  person  who  had  died  of  cancer  to  smoke  per- 
sistently at  a  rough  clay  pipe,  or  go  in  the  way  of 
getting  the  breast  bruised,  as  it  would  for  the  son 


CANCER.  193 

of  a  madman  to  indulge  freely  in  alcohol.  By  thus 
attending  to  the  laws  of  health  and  avoiding  injuries 
and  irritations  of  organs,  their  chances  of  living  to 
die  of  something  else  than  cancer  will  be  greatly 
increased,  of  this  they  may  be  certain,  while  their 
pleasure  and  usefulness  in  life  will  assuredly  not  be 
lessened. 

On  the  question  of  marriage  it  is  difficult  to  give 
advice.  The  thoughtful  man  05  woman  will  hesitate 
to  take  for  a  partner  a  member  of  a  family  in  which 
it  is  known  cancer  has  occurred — the  careless  and  the 
sordid  will  marry  as  of  yore. 

I  think  no  one  whose  parent  or  grandparent  has 
had  cancer — more  especially  if  the  ancestor  be  of 
the  same  sex — should  marry  without  much  thought 
for  the  possible  consequences.  But  if,  after  con- 
sideration, they  determine  to  risk  all,  then  let  them 
choose  as  partners  persons  whose  family  histories 
are  good;  persons  in  whose  families  neither  cancer, 
scrofula,  epilepsy,  drunkenness,  gout,  idiocy,  nor 
insanity  is  known,  remembering  that  in  doing  so 
they  are  lessening  the  sorrows  and  sufferings  of  their 
offspring. 

If  some  such  suggestions  as  these  were  carried  out 
for  a  period  of  time  equal  to  two  generations,  I  am 
convinced  that  the  amount  of  suffering  from  this 
disease  would  be  changed  from  what  it  now  is  to  a 
waning  quantity. 


CHAPTER  XIV. 

TUBERCULAR    DISEASE. 

TUBERCULAR  disease,  the  most  common  form  of  which 
is  that  known  as  phthisis  or  consumption,  has  been 
a  perfect  scourge  to  the  human  race  from  the  earliest 
times.  It  is  to  be  found  in  every  climate  and  in  all 
nations,  and  is  at  the  present  day  decimating  every 
civilised  community  on  the  face  of  the  earth. 

Much  has  been  done  in  England  within  the  past 
quarter  of  a  century  to  limit  the  ravages  of  these 
diseases ;  yet,  notwithstanding  all  that  sanitaiy  science 
has  yet  accomplished,  tubercular  diseases  were  respon- 
sible for  no  less  than  64,235  deaths  in  England  and 
Wales  during  the  year  1889.  This  is  equal  to  2213 
to  the  million  of  persons  living,  and  is  actually  an 
eighth  part  of  the  whole  of  the  deaths  recorded  during 
the  year. 

As  I  have  said,  tubercular  disease  has  been  known 
from  the  earliest  times.  Hippocrates  described  it  as 
attacking  the  lungs — the  most  common  seat  of  the 
disease  among  the  inhabitants  of  these  countries  at 
the  present  day — but  it  was  not  until  the  twelfth 
century  that  the  scrofulous  diathesis  was  recognised 


TUBERCULAR  DISEASE.  195 

and  described  by  Gordonius.  From  that  time  our 
knowledge  of  tubercular  disease  has  been  slowly  grow- 
ing; for  centuries,  progress,  if  there  were  any,  was 
very  small,  but  within  the  past  hundred  years  our 
knowledge  has  grown  apace,  investigation  having  been 
rewarded  time  after  time  by  discovery.  It  had  long 
been  known  that  tubercular  disease  could  be  com- 
municated by  inoculation  of  tubercular  matter  (as  the 
sputum  of  a  phthisical  person),  or  by  feeding  an 
animal  upon  the  flesh  of  animals  which  were  tuber- 
cular; but  it  was  not  until  1882  that  the  disease 
was  robbed  of  its  last  secret  by  the  discovery,  by 
Professor  Koch  of  Berlin,  of  the  micro-organism  upon 
which  all  tubercular  disease  depends.  This  eminent 
scientist  discovered  that  in  all  tubercular  growths 
there  are  to  be  found  myriads  of  micro-organisms 
having  characters  peculiar  to  themselves.  This  disease 
germ,  which  Koch  named  the  "tubercle  bacillus,"  is 
to  be  found  in  every  case  of  tubercular  disease,  and 
will,  if  introduced  into  the  system  of  an  apparently 
healthy  animal,  light  up  tubercular  disease.  It  can, 
moreover,  with  proper  attention  to  temperature,  and 
in  a  proper  medium,  be  multiplied  indefinitely  outside 
the  living  body  altogether,  and  such  artificially  culti- 
vated germs,  when  inoculated  upon  the  living  animal, 
produce  tubercular  disease,  just  as  would  matter  taken 
from  a  diseased  person  or  animal. 

Professor  Koch's  discovery  of  the  tubercle  bacillus, 
although  the  existence  of  the  germ  had  for  some 
time  been  suspected,  caused  great  stir  in  the  medical 


196  MARRIAGE  AND  DISEASE. 

world,  and  had  the  effect  of  greatly  unsettling  opinion 
upon  tubercular  disease  generally.  This  was  to  be 
expected,  for  what  had  been  looked  upon  for  ages  as 
one  of  the  most  hereditary  of  all  diseases,  was  suddenly 
proved  to  be  a  contagious  disease,  which  could  be  con- 
veyed from  person  to  person,  like  small-pox  or  scarlet 
fever,  and  doubt  at  once  arose  as  to  whether  hereditary 
predisposition  had  anything  whatever  to  do  with  the 
spread  of  the  disease.  This  doubt  was  fostered  by 
the  discovery  that  the  sources  of  infection  were  almost 
innumerable.  It  was  shown  that  the  disease  might 
be  conveyed  by  eating  the  flesh  of  animals  suffering 
from  the  disease,  or  by  drinking  the  milk  of  such; 
and  as  it  was  known  that  a  great  number  of  cattle 
were  tubercular,  it  was  evident  that  here  alone  was 
a  great  and  constant  source  of  contagion.  It  was 
further  pointed  out  that  the  sputa  of  persons  suffering 
from  phthisis  contain  myriads  of  bacilli,  and  as  such 
persons  are  constantly  coughing  and  spitting,  there 
must  be  grave  danger  to  all  who  live  with,  work 
with,  or  have  intimate  relations  with,  such  persons. 
Nor  did  the  danger  of  infection  from  phthisical 
persons  stop  eyen  here,  for  it  was  asserted  that  this 
bacillus-laden  sputum,  after  it  had  become  hard  and 
dry,  might  be  broken  up,  to  float  as  minute  particles 
in  the  air,  and  be  inhaled  by  any  one  breathing  the 
contaminated  atmosphere,  the  bacilli  in  such  dried 
sputum  retaining  sufficient  vitality  to  set  up  tuber- 
cular disease  in  the  person  inhaling  it.  In  fact,  the 
disease  germ  was  almost  ubiquitous,  which  fact  alone 


TUBERCULAR  DISEASE.  197 

was  sufficient  to  account  for  the  prevalence  of  the 
disease.  Indeed  the  wonder  was,  not  that  so  many 
suffered,  but  that  more  did  not  suffer  from  a  disease, 
the  germs  of  which  were  to  be  found  on  every  hand. 
This  was  the  position  taken  up  by  some  immediately 
after  Koch's  discovery,  but  already  opinion  on  the 
subject  is  toning  down,  and  at  present  there  are 
very  few  who  do  not  admit  the  existence  of  a  pre- 
disposition to  tubercular  disease,  which  is  hereditarily 
transmitted. 

It  has  been  proved  conclusively  that  tubercular 
disease  can  be  conveyed  from  individual  to  individual, 
apparently  regardless  of  temperament  or  diathesis, 
by  the  introduction  of  the  tubercle  bacillus  into  the 
system,  but  that  there  exists  a  diathesis  which  pre- 
disposes the  owner  to  the  attack  of  this  particular 
disease  germ,  there  can  be  no  possible  doubt.  That 
this  peculiar  constitutional  state  is  a  degeneration, 
that  it  is,  like  every  other  degeneration,  hereditary, 
and  that  it  is  frequently  associated,  both  in  individual 
and  family,  with  other  degenerate  conditions,  such 
as  idiocy,  insanity,  deaf-mutism,  cancer,  drunkenness, 
epilepsy,  and  crime,  it  is  now  my  business  to  prove. 

It  is  impossible  to  guess  to  what  this  great  discovery 
of  Koch's  may  lead  in  the  near  future.  Since  the 
bacillus  can  be  cultivated  outside  the  body  in  arti- 
ficial media,  there  is  no  reason  why,  by  varying  the 
conditions  under  which  it  is  so  cultivated,  the  germ 
itself  should  not  be  altered  in  character  and  rendered 
less  virulent.  This  might  lead  to  protective  inocula- 


198  MARRIAGE  AND  DISEASE. 

tion  like  that  practised  against  small-pox.  Nor  is 
there,  seemingly,  any  reason  why  some  other  micro- 
organism or  chemical  compound  should  not  be  dis- 
covered which,  itself  innocuous  to  the  animal  organism, 
would  materially  modify  the  virulence  of  the  tubercle 
bacillus  in  the  system,  or  destroy  the  noxious  germ 
altogether.  Indeed  it  might  be  said  that  "all  things 
are  possible"  in  this  department  of  medical  science. 
At  present  hundreds  of  workers  all  over  the  world 
are  labouring  earnestly  in  this  field  of  study,  and  are 
adding  almost  daily  to  our  knowledge  of  these  seeds 
of  disease.  Science  can  never  eradicate  disease,  but  it 
can  prune  it  and  keep  it  within  reasonable  bounds ;  and 
the  discovery  of  the  micro-organisms,  upon  the  presence 
of  which  so  many  diseases  have  already  been  proved  to 
depend,  will  vastly  aid  Science  in  this  work. 

Let  us  now  briefly  consider  the  diathesis  of  which 
we  have  spoken,  which  predisposes  so  strongly  to  the 
attack  of  tubercular  disease. 

As  there  are  two  distinct  types  included  in  the 
tubercular  diathesis,  it  will  simplify  matters  to  take 
each  type  separately.  I  shall  therefore  first  give  a 
very  brief  enumeration  of  the  characters  typical  of 
what  we  shall  call  the  Phthisical  Diathesis,  and  after- 
wards a  short  description  of  the  true  Scrofulous 
Diathesis. 

What  we  have  called  the  phthisical  diathesis  is 
generally  marked  by  the  presence  of  a  clear  com- 
plexion, a  fine  skin,  and  features  well  cut  and  often 
beautiful.  The  lips  are  red,  the  teeth  pearly  white, 


TUBERCULAR  DISEASE.  199 

though  liable  to  early  decay,  and  the  eyes  are  large 
and  full,  the  pupils  being  widely  dilated  and  the 
white  of  the  eye  beautifully  clear.  The  eyelashes  are 
long,  curved,  and  silky,  and  the  blue  veins  show 
distinctly  through  the  clear  thin  skin ;  the  bones  are 
light,  the  hands  and  feet  well  formed,  the  stature 
often  tall,  and  the  whole  figure  slightly  and  grace- 
fully built.  Persons  of  this  type  generally  remain 
spare,  and  they  have  a  strong  dislike  to  every  kind 
of  fatty  food.  They  are  vivacious  and  excitable,  and 
the  intellectual  faculties  are  often  highly  developed. 
Even  at  an  early  age  children  of  this  temperament  in 
many  cases  show  a  marvellous  intellectual  activity, 
and  it  is  observation  of  the  regularity  with  which 
such  precocious  tubercular  children  die  that  has  given 
rise  to  the  common  saying,  when  speaking  of  excep- 
tionally clever  children,  that  they  may  be  "  too  wise 
to  live  long." 

These  persons  are  wanting  in  stamina  in  the  widest 
sense  of  the  term.  They  are  incapable  of  prolonged 
exertion  either  of  mind  or  body,  and  break  down 
under  conditions  which  would  not  prove  injurious  to 
the  healthy.  They  are  continually  taking  "colds," 
and  are  specially  prone  all  through  life  to  affections  of 
an  inflammatory  character. 

Although  large  families  are  often  born  to  parents 
of  this  type,  the  children  are  deficient  in  vital  force, 
and  are  carried  off  in  such  numbers  during  infancy  by 
convulsions,  brain  fever,  water  on  the  brain,  exhaust- 
ing diarrhoea,  and  other  ailments,  that  only  a  small 


200  MARRIAGE  AND  DISEASE. 

proportion  of  those  born  ever  arrive  at  maturity,  and 
few  indeed  reach  old  age.  Sooner  or  later  in  life 
the  majority  of  these  persons  develop  consumption ; 
many  are  so  carried  off  even  in  infancy  ;  great  numbers 
succumb  before  or  about  the  time  of  adolescence,  and 
only  a  small  remnant  live  beyond  thirty-five  or  forty 
years  of  age. 

Persons  of  this  phthisical  temperament  are  also 
remarkably  prone  to  fatal  degenerative  changes  (fatty 
degeneration)  of  certain  vital  organs,  as  the  liver  and 
kidneys.  It  is  also  to  be  noticed  that  in  them  the 
generative  organs  are  often  but  poorly  developed? 
which  in  itself  is  positive  evidence  of  progressive 
decay  of  the  stock.  It  is  true  that  the  intellectual 
faculties  are  often  active  and  well  developed,  but  even 
here  there  are  unmistakable  signs  of  the  decay  which 
has  attacked  the  system  generally.  However  brilliant 
intellectually,  they  are  as  a  class  emotional,  impres- 
sionable, and  impulsive,  and  there  is  a  marked  absence 
of  that  stability  which  indicates  true  mental  strength. 
From  slight  causes  they  develop  convulsions  in 
infancy,  chorea,  hysteria,  and  other  nervous  disorders 
in  youth,  and  acute  attacks  of  insanity  in  adult  life. 

This  diathesis  appears  to  be  built  up  with  equal 
certainty  by  impure  air,  drunkenness,  and  want 
among  the  poor,  and  by  dissipation  and  enervating 
luxuries  among  the  rich.  From  either  set  of  causes 
it  is  capable  of  rapid  development,  and  it  is  trans- 
mitted to  the  offspring  with  very  great  certainty. 
By  injudicious  marriages  and  persistent  ignoring  of 


TUBERCULAR  DISEASE.  201 

the  laws  of  health  the  necessarily  fatal  type  is  soon 
reached,  and  to  this  must  be  attributed  the  extinction 
of  hundreds  of  families  every  year.  In  some  families, 
even  in  the  highest  ranks  of  society,  the  susceptibility 
to  the  tubercle  bacillus  becomes  so  great,  that,  despite 
all  modern  science  backed  by  wealth  can  do,  the 
children  die  one  after  another  in  infancy,  or  succumb 
on  the  approach  of  adolescence.  In  other  cases  the 
degeneration  from  intermarriage  or  some  other  cause 
becomes  more  or  less  mixed  in  character,  and  while 
some  of  the  children  succumb  to  tubercular  disease 
in  infancy  or  later  in  life,  idiocy,  suicide,  epilepsy, 
insanity,  or  the  true  scrofulous  cachexia  will  appear 
in  others. 

This  phthisical  diathesis  might  be  described  as  a 
general  degeneration,  very  closely  related  to  the 
neurotic,  which  occurs  in  families  once  decidedly 
above  the  lower  stages  of  development,  but  now  on 
the  down  grade  of  general  decay.  Such  family  decay 
being  the  result  of  the  repeated  exposure  of  ancestors 
to  the  devitalising  attack  of  the  tubercle  bacillus, 
or  some  other  exhausting  disease,  or  to  some  of  the 
thousand  and  one  evil  influences  which  are  constantly 
at  work  producing  progressive  deterioration  among  all 
civilised  peoples. 

Let  us  now  look  at  the  true  scrofulous  type,  which 
in  many,  indeed  in  most  points,  is  the  extreme  opposite 
of  that  we  have  just  been  considering.  Here  the 
skin  is  usually  thick  and  sallow  or  pale  and  spongy ; 
the  features  are  coarse  and  ill  cut;  the  eyes  dull, 

14 


202  MARRIAGE  AND  DISEASE. 

and  the  mouth  large.  The  margins  of  the  nostrils 
and  the  upper  lip  are  frequently  swollen,  and  the 
edges  of  the  eyelids,  devoid  of  hairs,  often  present 
a  red,  raw  margin,  which  greatly  disfigures  the  face. 
The  whole  expression  is  dull,  heavy,  and  more  or  less 
repulsive,  the  very  antipodes  of  the  quick,  eager, 
apirituelU,  and  often  beautiful  face  seen  in  the  phthi- 
sical type.  Nor  does  the  dissimilarity  to  type  stop 
here,  for  in  the  scrofulous  we  find  the  bones  thick 
and  heavy,  with  their  ends,  and  consequently  the 
joints,  large.  The  head  is  often  large  and  misshapen, 
the  hands  short,  the  fingers  thick,  the  figure  stunted, 
with  a  decided  inclination  to  pot  belly.  Sometimes 
the  skin  is  so  loaded  with  greasy  sebaceous  matter  as 
to  give  it  a  dirty,  scaly  look.  Discharges  from  the 
eyes,  nose,  and  ears  are  common,  and  such  discharges 
are  often  most  offensive,  as  is  frequently  the  perspira- 
tion of  the  feet.  In  such  individuals  the  circulation 
is'  always  weak,  as  shown  by  the  cold  hands  and  feet ; 
the  digestion  is  generally  poor,  and  they  are  liable  to 
"  colds  "  on  the  slightest  exposure.  The  glands  round 
the  jaws  are  nearly  always  more  or  less  enlarged,  and 
they  are  liable  to  the  formation  of  abscesses,  which 
run  a  remarkably  chronic  course.  Slight  injuries, 
which  in  the  healthy  would  hardly  be  noticed,  in  the 
scrofulous  set  up  inflammations  which  often  lead  to 
ulcerations  of  the  soft  tissues,  destruction  of  joints, 
and  disease  of  the  bones  themselves,  which  often  con- 
tinue for  years.  They  are  also  liable  to  many  of  the 
most  severe  and  intractable  forms  of  skin  disease,  in 


TUBERCULAR  DISEASE.  203 

their  case  often  accompanied  by  the  formation  of  pus, 
while  they  have  almost  a  monopoly  of  lupus,  a  disease 
which  often  eats  away  considerable  portions  of  the 
face  and  other  parts,  and  which  appears  to  stand  mid- 
way between  scrofula  and  cancer. 

Occasionally  the  mental  faculties  in  the  scrofulous 
are  preternaturally  developed  during  early  life,  but 
such  development  is  exceptional ;  as  a  rule,  they  are 
dull,  and  altogether  of  a  low  type  intellectually. 

It  is  evident  from  the  foregoing  brief  and  imperfect 
descriptions  that  the  scrofulous  is  a  very  much  lower 
type  of  degeneration  than  the  phthisical,  and,  as  we 
would  expect,  we  find  it  occurring  much  more  com- 
monly in  association  with  other  extreme  forms  of 
degeneration,  such  as  idiocy,  imbecility,  and  physical 
deformity. 

That  the  tubercular  diathesis,  whether  of  the 
phthisical  or  scrofulous  type,  is  a  true  degeneration, 
is  evident  from  its  hereditary  character,  the  frequency 
with  which  it  appears  associated  with  other  degenera- 
tions in  the  individual,  and  the  perfect  interchange- 
ability  existing  between  it  and  most  of  the  other 
expressions  of  decay  in  the  family. 

Of  this  relationship  and  interchangeability  with 
other  signs  of  family  decadence  we  could  not  have  a 
much  better  example  than  is  offered  in  the  family 
history  given  at  page  186,  in  the  chapter  on  cancer. 
In  that  case  the  cancerous  father  and  neurotic  mother 
produced  highly  neurotic  and  cancerous  male  children, 
while  the  females  were  so  devitalised  by  the  combined 


204  MARRIAGE  AND  DISEASE. 

parental  taints,  that  all  succumbed  to  tubercular 
disease.  The  connection  between  cancer  and  tuber- 
cular disease  was  pointed  out  by  Sir  William  Gull, 
who  called  attention  to  the  frequency  with  which 
cancerous  parents,  or  parents  belonging  to  families 
in  which  cancer  was  common,  begot  scrofulous 
children. 

The  frequency  with  which  the  scrofulous  diathesis 
is  met  with  among  idiots  is  most  remarkable.  Dr. 
Ireland,  one  of  the  greatest  living  authorities  upon 
idiocy,  estimates  that  at  least  two-thirds  of  all  idiots 
are  scrofulous ;  while  Dr.  Clouston  of  the  Royal 
Edinburgh  Asylum,  who  has  closely  studied  the  rela- 
tionship existing  between  the  tubercular  diathesis  and 
insanity,  treats  the  matter  as  beyond  dispute,  merely 
remarking  that  "  the  frequent  association  of  the 
depraved  nutritive  condition  known  as  l  scrofulous ' 
with  idiocy  and  congenital  imbecility  is  well  known, 
and  universally  recognised  by  those  who  have  had 
experience  in  such  cases/' 

Further  proof  of  the  fact  that  the  scrofulous  tem- 
perament is  a  deeper  level  of  degeneration  than  the 
phthisical,  is  found  in  the  facts  that  the  phthisical 
rarely  or  never  develop  the  purely  scrofulous  forms 
of  disease,  although  the  scrofulous  often  develop  and 
die  of  tubercular  disease  of  the  lungs ;  and  that  the 
children  of  the  phthisical  are  very  often  scrofulous, 
whatever  other  mark  of  degeneration  they  may  bear. 
This  could  *ot  have  stronger  support  than  it  receives 
at  the  hands  of  Dr.  Fletcher  Beach,  the  superin- 


TUBERCULAR  DISEASE.  205 

tendent  of  the  Asylum  for  Idiots  at  Darenth,  who, 
in  the  course  of  his  extended  inquiries  into  the 
causes  of  idiocy,  found  that  phthisis,  either  alone  or 
in  combination  with  some  other  degenerate  condition, 
as  insanity,  epilepsy,  or  drunkenness,  was  present  in 
50  per  cent,  of  the  parents  of  all  idiots  admitted 
into  his  asylum  ;  and  as  two-thirds  of  these  idiots 
are  themselves  scrofulous,  it  is  clear  that  phthisis 
in  the  parent  not  only  deepens  to  scrofula  in  the 
child,  but  to  that  lowest  of  all  types  of  humanity, 
the  scrofulous  idiot. 

As  to  the  very  close  relationship  existing  between 
insanity  and  the  phthisical  type  of  the  tubercular 
diathesis,  there  is  not  room  for  the  smallest  doubt. 
That  the  phthisical  and  insane  diatheses  are  inter- 
changeable is  proved  to  the  asylum  physician  every 
day.  Lugol  found  insanity  so  common  amongst  the 
parents  of  scrofulous  and  phthisical  persons,  that 
he  treated  of  hereditary  scrofula  descending  from 
paralytic,  epileptic,  and  insane  parents.  Schroeder 
van  der  Kolk,  a  quarter  of  a  century  ago,  showed  that 
phthisis  and  insanity  are  interchangeable.  So  long 
ago  as  1863  Dr.  Clouston  described  a  form  of 
insanity  peculiar  to  those  of  the  phthisical  diathesis 
and  their  descendants,  and  said  he  could  count 
hereditary  predisposition  in  7  per  cent,  more  of  such 
cases  than  of  the  insane  generally.  After  twenty- 
seven  years'  study  and  observation  he  remains  of 
the  same  opinion.  Speaking  of  phthisis  and  insanity, 
he  says : — "  It  is  surprising  how  often  both  diseases 


206  MARRIAGE  AND  DISEASE. 

occur  in  different  members  of  the  same  family.  No 
physician  in  extensive  practice  but  has  met  with 
many  such  families."*  On  the  same  point  Dr. 
Maudsley  writes  : — "  There  is  no  question  in  my  mind 
that  insanity  and  phthisis  are  met  with  as  con- 
comitant or  sequent  effects  in  the  course  of  family 
decadence."  t 

Again,  it  is  a  matter  of  common  observation  that 
the  children  of  the  gouty  and  the  syphilitic  are 
very  frequently  scrofulous,  and  to  these,  and  the 
insane  taint,  .aided  by  dissipation  and  enervating 
luxuries,  is  to  be  attributed  the  appearance  of  a  type 
so  degraded  as  the  scrofulous  among  the  children  of 
aristocratic  and  even  royal  families. 

Habitual  drunkenness  in  the  parents  is  another 
fruitful  source  of  the  scrofulous  temperament,  but 
this  has  already  been  shown  to  be  so  essentially 
an  expression  of  the  neurotic  type,  that  it  is  only 
necessary  to  mention  it  here. 

Another  cause  of  scrofula  in  children,  and  one 
which  gives  further  proof  of  the  degenerate  character 
of  the  type,  is  senility  in  the  parents.  It  has  for 
ages  been  popularly  believed  that  the  child  begotten 
of  the  aged  father  has  not  the  vital  energy  and 
recuperative  power  of  the  child  of  the  father  in  his 
prime ;  and  that  this  belief  is  well  founded  the 
recent  investigations  of  Marro,  Dr.  Langdon  Down, 
Korosi,  and  others  prove  conclusively.  All  observers 
agree  that  the  senility  of  the  father  may,  to  a  great 

*  Loc.  cU.  t  "Pathology  of  Mind,"  p.   112. 


TUBERCULAR  DISEASE.  207 

extent,  be  neutralised  by  the  youth  and  vigour  of 
the  mother,  but  when  the  mother  has  passed  her 
youth,  the  senility* of  the  father  is  invariably  more 
or  less  disastrous  to  the  child.  It  is  most  wonderful 
how  many  idiots,  scrofulous  and  otherwise,  instinctive 
criminals,  and  drunkards,  are  found  upon  inquiry  to 
belong  to  the  class  whose  mothers  were  no  longer 
young,  and  whose  fathers  were  in  the  decline  of  life, 
when  they  were  begotten.  This  class  also  show  how 
small  is  their  inheritance  of  vitality  by  falling  a  prey 
in  great  numbers  to  tubercular  affections. 

Looking  upon  the  instinctive  criminal  as  we  do, 
as  the  representative  of  a  decaying  race,  we  naturally 
expect  to  find  tubercular  disease  actively  at  work 
among  this  class,  and  in  such  expectation  we  are 
not  disappointed.  The  fact  is,  the  majority  of  this 
wretched  class  die  of  tubercular  and  nervous  diseases. 
Here  again  the  relationship  of  the  tubercular  and 
nervous  affections  is  to  be  noted.  The  instinctive 
criminal  class  belong  to  the  unfit;  ."they  are  scrofu- 
lous, not  seldom  deformed,  with  badly  formed  angular 
heads ;  are  stupid,  sluggish,  deficient  in  vital  energy, 
and  sometimes  afflicted  with  epilepsy.  .  .  .  They 
spring  from  families  in  which  insanity,  epilepsy,  or 
some  other  neurosis  exists,  and  the  diseases  from 
which  they  suffer  and  of  which  they  die  are  chiefly 
tubercular  diseases  and  diseases  of  the  nervous 
system."  *  Mr.  Bruce  Thomson,  Marro,  Lombroso, 
Dr.  Wey,  and  every  other  observer  who  has  studied 
*  Maudsley's  "  Responsibility  in  Mental  Disease." 


208  MARRIAGE  AND  DISEASE. 

the  criminal,  agree  that  tubercular  disease  is  con- 
stantly met  with  in  criminals  themselves,  and  in 
their  ancestors  and  descendants,  a*hd  that  a  majority 
of  the  whole  total  succumb  to  these  diseases.  Recently 
Dr.  Pauline  Tarnowsky  has  been  very  closely  studying 
the  prostitute,  who  may  be  taken  as  the  analogue  of 
the  male  instinctive  criminal  of  the  petty  class,  and 
of  150  women  of  this  class  whose  family  history 
she  was  able  to  get,  she  found  phthisical  parentage 
in  no  less  than  44  per.  cent.* 

Thus,  we  see,  are  the  family  degenerations  all 
allied,  the  scrofulous  being  related  to  the  cancerous, 
gouty,  epileptic,  insane,  syphilitic,  drunken,  and  crimi- 
nal, and  all  these  being  related  to  each  other. 

It  must  not,  however,  be  inferred  from  all  this 
that  tubercular  disease  only  attacks  those  inheriting 
a  predisposition  thereto.  True,  the  family  taint 
can  be  traced  in  30  to  50  per  cent,  of  all  phthisical 
persons,  and  in  quite  as  large  a  proportion  of  those 
suffering  from  scrofulous  disease  (and  that  only 
reckoning  taint  as  existing  where  tubercular  disease 
has  been  present  in  the  ancestors),  but  that  inherited 
predisposition  is  absolutely  necessary  to  the  develop- 
ment of  these  diseases  has  been  proved  to  be 
erroneous.  As  a  rule,  the  tubercle  bacillus  only 
attacks  those  deficient  in  vitality,  but  it  is  not 
necessary  that  this  deficiency  should  be  congenital ; 
such  vital  poverty  may  be  acquired.  Of  course, 
individuals  thus  vitally  reduced — brought  below  par, 

*  "Etude  Anthropom^tiique  sur  les  Prostitutes  et  les  Voleuses." 


TUBERCULAR  DISEASE.  209 

so  to  speak — are  specially  liable  to  the  attack  of 
all  other  disease  germs  as  well  as  that  of  tubercle ; 
or,  if  not  specially  liable,  they  are,  at  least,  less 
capable  of  resistance  when  they  are  attacked.  Still 
it  must  be  recognised  that  the  tubercle  bacillus  has 
a  special  affinity  for  the  tissues  of  those  wanting  in 
vital  force.  Some  disease  germs  appear  to  attack 
the  robust  and  the  feeble  with  equal  frequency  and 
virulence ;  others,  as  that  of  typhoid  fever,  seem 
actually  to  prefer  the  tissues  of  the  physically  well- 
to-do,  but  the  tubercle  bacillus  has  a  decided  pre- 
ference for  those  bankrupt  in  vital  energy  from  any 
cause,  except  perhaps  senility. 

I  would  put  it  in  this  way : — The  tubercle  bacil- 
lus being  almost  ubiquitous,  so  soon  as  the  system 
reaches  a  certain  level  of  vital  depravity,  which  I 
would  call  "  the  tubercular  level,"  the  individual 
becomes  liable  to  the  attack  of  the  bacillus.  In  some 
cases,  small-pox,  syphilis,  or  other  exhausting  disease, 
leaves  the  system  for  a  time  in  an  impoverished 
state,  and  before  the  vitality  is  restored,  tubercular 
disease  is  set  up  ;  in  a  host  of  others,  starvation,  dirt, 
habitual  drunkenness,  and  want  of  fresh  air  reduce 
the  system  to  the  level  of  susceptibility  with  like 
result;  but  in  the  vast  majority  who  develop  tuber- 
cular disease,  the  protective  vital  level  has  never  been 
reached,  a  wretched  parentage  being  unable  to  confer 
so  much.  Such  individuals  are  from  the  moment 
of  conception  helpless  against  the  attack  of  the 
tubercle  bacillus,  and  succumb  on  first  contact  with 


2io  MARRIAGE  AND  DISEASE. 

the  germ.  We  have  instances  of  this  wretched  class 
in  the  scrofulous  idiot  and  in  the  children  of  those 
families  where  the  offspring  die  off  one  after  another, 
soon  after  birth,  of  various  tubercular  affections. 

The  sources  of  infection  by  the  tubercle  bacillus 
are  almost  innumerable.  It  may  be  inhaled  with 
matter  floating  in  the  air,  or  be  introduced  through 
any  cut,  scratch,  or  other  breach  in  the  skin  or 
mucous  surface,  or  it  may  be  taken  into  the  system 
with  food.  Cattle  are  specially  liable  to  tubercular 
disease.  Herr  von  Gossler,  in  his  speech  before  the 
Prussian  Diet,  stated  that  I  o  per  cent,  of  all  horned 
cattle  slaughtered  for  food  are  tuberculous.  This 
estimate  may  be  high,  but  it  is  certain  that  a  vast 
number  of  the  animals  are  tuberculous,  and  that  the 
consumption  of  the  flesh  of  these  diseased  animals 
is  one  of  the  greatest  dangers  to  which  the  human 
species  is  exposed.  The  milk  of  such  cattle  often 
swarms  with  bacilli,  and  the  use  of  this,  or  of  butter 
made  from  such  milk,  is  dangerous  in  the  extreme. 

To  lessen  as  far  as  possible  the  risk  of  infection, 
the  ventilation  of  all  rooms  in  which  either  persons 
or  animals  live  or  work  should  be  strictly  attended  to. 
Living  or  sleeping  in  the  same  room  with  one  suffer- 
ing from  tubercle  should  never  be  permitted.  The 
sputa  of  phthisical  individuals  should  not  be  ejected 
here,  there,  and  everywhere,  but  received  in  a  vessel 
containing  some  strong  disinfectant,  and  be  burnt 
or  buried  afterwards.  Cattle  kept  for  dairy  purposes 
should  be  regularly  examined,  and  those  found  tainted 


TUBERCULAR  DISEASE.  211 

with  tubercular  disease  at  once  destroyed.  All  meat 
offered  for  sale  should  first  be  examined  by  experts. 
And  lastly,  all  animal  food,  from  whatever  source, 
should  be  properly  and  sufficiently  cooked.  A  high 
temperature  kills  the  bacillus,  and  the  danger  of  in- 
fection from  diseased  meat  might  be  greatly  reduced 
if  all  animal  food  were  properly  cooked. 

The  tubercle  bacillus  attacks  most  animals  whose 
bodily  temperature  favours  its  growth.  It  is  common 
in  beasts  and  birds,  and  has  even  been  found  in 
reptiles,  but  the  temperature  of  these  latter  is  not, 
under  ordinary  circumstances,  sufficiently  high  for  its 
growth.  As  I  have  said,  it  is  extremely  common  in 
the  ox,  though  why  it  should,  has  not  yet  been  ex- 
plained. It  is  the  cause  of  death  in  the  majority  of 
monkeys,  elephants,  lions,  tigers,  and  other  wild 
animals  and  birds  held  in  captivity.  These  animals 
being  robbed  of  their  natural  exercise  in  the  open  air, 
too  often  huddled  together  in  unhealthy  pens  or  cages, 
and  poorly  or  improperly  fed,  often  doubtless  upon 
tuberculous  flesh,  become  broken  in  health,  and  so 
devitalised  that  they  fall  easy  victims  to  the  disease 
germs,  just  as  man  does  under  like  conditions. 

In  quadrumana  the  disease  runs  the  same  course 
as  in  man ;  but  in  other  animals,  mammals  and  birds, 
its  course  is  often  so  very  different,  that  it  is  only 
the  presence  of  the  micro-organism  which  proves  the 
identity  of  the  diseased  conditions. 

It  attacks  some  animals  much  more  frequently  than 
others.  Thus  it  is  very  common  in  the  ox,  and  very 


212  MARRIAGE  AND  DISEASE. 

rare  in  the  horse,  a  perfect  scourge  among  grain- 
eating  birds,  and  much  rarer  among  those  that  eat 
flesh.  Why  this  predisposition  should  exist  in  some 
animals,  we  do  not  at  present  know,  any  more  than 
why  the  negro  and  the  West  Indian  Creole  should  be 
specially  susceptible  to  the  attack  of  the  bacillus ; 
but  it  is  possible  that  as  our  knowledge  grows,  we 
may  come  to  understand  this  too. 

As  to  advice  respecting  marriage,  it  may  at  once 
be  said  that  those  already  suffering  from  any  form  of 
tubercular  disease  should  not  marry.  Neither  should 
any  one  marry  a  member  of  a  family  in  which  con- 
sumption, or  other  form  of  tubercular  disease,  is 
common.  The  clear-skinned,  bright-eyed,  eager,  ethe- 
real creature  may  charm  the  eye,  and  she  may  be 
good  as  she  is  beautiful,  but  she  can  never  be  the 
mother  of  strong  and  healthy  children.  It  is  possible 
that  in  the  near  future  Science  may  be  able  to  eradi- 
cate the  tubercle  bacillus  from  any  individual  it  has 
attacked ;  but  even  if  this  feat  of  Science  were  accom- 
plished, it  is  not  too  much  to  say,  that  persons  of 
such  low  vitality  as  most  of  these  healed  ones  would 
be,  would  hardly  be  the  kind  of  partners  sensible 
men  and  women  who  wished  to  live  in  distant  pos- 
terity would  choose.  Until  Science  can  not  only 
eradicate  the  disease,  but  instil  sufficient  vitality  into 
the  purified  one  to  prevent  a  re-invasion  of  the  system 
by  the  disease  germ,  those  who  are  tubercular  or 
have  been  tubercular  cannot  be  looked  upon  as  favour- 
able candidates  for  marriage. 


TUBERCULAR  DISEASE.  213 

On  the  other  hand,  all  those  who,  though  not  them- 
selves tubercular,  are  members  of  "  delicate  families," 
families  in  which  tubercular  disease  has  appeared, 
should,  before  entering  the  marriage  state,  lay  their 
case  honestly  before  their  medical  adviser,  and  take 
his  advice.  Much  can  be  done  for  the  children  of 
delicate  parents  by  judicious  treatment,  but  to  be  as 
effectual  as  possible,  it  should  be  begun  with  the  life 
of  the  child,  if  not  earlier.  The  child  can  be  as 
effectually  treated  before  birth  through  the  system  of 
the  mother,  as  it  can  be  after  birth,  and  such  preven- 
tive treatment  cannot  be  begun  too  soon  or  carried 
out  too  rigidly. 


CHAPTER  XV. 

GOUT. 

"  Gout  is  one  of  the  most  striking  examples  of  hereditary  disease, 
and  once  established,  it  may  be  transmitted  for  several  generations, 
even  when  every  endeavour  is  made  to  eradicate  it ;  but  as  the 
contrary  is  generally  the  case,  the  malady  being,  as  a  rule,  more  or 
less  intensified  by  pernicious  habits,  it  becomes  in  most  cases  a 
permanent  legacy." — SIE  FEEDEEICK  T.  EGBERTS.* 

THIS  is  a  disease  of  great  antiquity.  As  far  as  we 
can  go  back  in  medical  literature,  it  is  one  of  the 
diseases  which  we  find  described,  and  some  of  the 
earliest  of  these  descriptions  come  wonderfully  near  to 
what  we  find  the  disease  to-day.  Hippocrates,  three 
hundred  years  before  the  time  of  Christ,  described 
this  disease  with  accuracy,  and  later,  Celsus,  Galen, 
Aretseus,  Cselius  Aurelianus,  and  many  others  wrote 
concerning  gout,  hitting  off  its  leading  characteristics 
with  great  fidelity. 

Gout  is  a  disease  of  civilisation.  It  is  one  of  the 
degenerate  conditions  induced  by  interference  with  the 
natural  life  of  the  human  animal.  So  long  as  man 
remained  in  the  natural  state,  and  gained  by  physical 
exertion  his  living,  this  disease  was  unknown — in  fact, 
*  Quain's  "  Dictionary  of  Medicine." 


GOUT.  215 

it  is  unknown  among  the  savage  peoples  even  at  the 
present  day ;  but  so  soon  as  he  entered  upon  the 
civilised  state,  became  a  chief  or  a  king,  and  lounged 
in  idleness  while  others  performed  that  labour  which 
must  be  done  by  or  for  every  creature,  if  the  creature 
is  to  exist,  then  this  disease  appeared ;  and  as  civilisa- 
tion spread,  and  the.  non- working  class  increased,  so  did 
gout.  In  fact,  so  soon  as  man  began  to  eat  too  much 
and  labour  too  little,  gout  attacked  him.  It  is  above 
all  other  diseases  the  scourge  of  the  opulent  and  idle. 
The  vegetarians — those  hopeless  faddists — have 
asserted  that  gout,  in  common  with  every  other  ill 
that  flesh  is  heir  to,  is  the  direct  result  of  animal  food. 
So  long,  they  say,  as  man  remained  a  vegetarian,  gout 
was  unknown.  To  this  we  would  reply  :  Yes,  and  for 
ages  after  he  had  ceased  to  be  a  vegetarian.  It  was 
only  when  man  became  indolent  and  lazy,  on  discover- 
ing that  he  could,  by  exercising  his  ingenuity,  procure 
more  than  enough  of  the  best  of  the  wherewithal  to 
sustain  life  without  physical  exertion,  that  the  disease 
appeared.  The  North  American  Indians  and  many 
other  peoples  of  whom  we  know  were  largely,  if  not 
entirely  flesh-eaters,  yet  gout  among  such  peoples  was 
unknown.  And  why  ?  Simply  because  the  very 
active  life  they  lived  in  the  open  air  used  up  all  the 
food  stuff  taken,  and  accumulation  was  impossible. 
The  organs  were  never  overloaded,  or,  if  they  were,  it 
was  only  on  occasions  which  alternated  with  periods 
of  healthful  want,  consequently  disease  from  that  cause 
was  absent. 


2i6  MARRIAGE  AND  DISEASE. 

Mr.  Jonathan  Hutchinson  has  said : — ft  Had  man- 
kind continued  to  be  vegetable  feeders,  and  never 
known  the  use  of  wine  or  beer,  we  should  have  had 
no  experience  of  gout."  But  with  Mr.  Hutchinson, 
even  when  he  adds  the  "  sole  cause "  of  the  total 
abstinence  party  to  that  of  the  vegetarians,  I  cannot 
agree.  I  can  see  no  reason  why  by  gluttony  and 
indolence  the  system  could  not  be  overcharged  with 
nitrogenous  matters  from  the  vegetable  world,  and, 
if  this  condition  were  maintained  for  a  few  genera- 
tions, why  we  should  not  have  gout  as  a  consequence. 
Animal  food  is  more  nitrogenous  than  most,  and  less 
nitrogenous  than  some  vegetable  products,  and  I  fail 
to  see  why  the  nitrogenous  constituents  of  a  vegetable 
diet  should  be  less  injurious  than  those  of  an  animal 
diet.  So  far  as  we  know  at  present,  if  taken  in  equal 
quantity  and  equally  diluted,  the  result  of  animal  and 
vegetable  products  is  much  the  same.  Again,  as  to 
wine  and  beer,  both,  by  the  way,  vegetable  products, 
it  is  clear  that  it  is  not  the  alcohol,  but  rather  the 
sugary  matters  which  are  the  gout-producers.  Our 
port  wines,  and  Burgundies,  and  beer,  and,  most 
potent  of  all,  our  stout,  are  recognised  as  our  great 
fluid  gout-producers,  while  whisky,  which  is  a  much 
more  concentrated  solution  of  alcohol  than  any  of 
them,  has  little  if  any  effect  in  the  evolution  of  this 
disease. 

The  fact  of  the  matter  is,  the  cause  of  gout  is 
indolence  coupled  with  gluttony.  Rich  foods  are 
freely  partaken  of,  and  sufficient  exercise  to  burn  that 


GOUT.  217 

food  off  is  not  taken,  hence  the  organs  whose  business 
it  is  to  cast  out  of  the  system  effete  matters  have  a 
strain  put  upon  them.  This  strain  sooner  or  later 
causes  disorder  of  those  organs,  which  further  compli- 
cates matters,  and  soon  leads  to  retention  within  the 
system  of  matters  offensive  to  health.  The  kidneys 
are  the  great  blood-cleansers,  and  these  organs  are 
more  or  less  diseased  in  every  case  of  gout. 

Abernethy's  receipt  for  the  cure  of  gout,  "  Live  on 
sixpence  a  day  and  earn  it,"  still  holds  good,  and  if 
the  humble  coin  have  been  earned  by  honest,  healthy, 
physical  toil,  I  care  not  whether  it  be  expended  upon 
steak  and  kidney-pie  or  upon  potatoes  and  milk. 
In  neither  case  will  the  input  of  material  exceed  that 
needful  as  a  force-producer,  and  so  no  accumulation 
can  arise  to  clog  the  system.  I  admit  that  the 
glutton  may  be  more  likely  to  overload  the  system, 
feeding  upon  rich  dishes  of  animal  food,  than  feeding 
upon  the  less  succulent  yet  no  less  rich  vegetables. 
But  if  the  rising  generation  of  vegetarian  cooks  can 
produce  equally  seductive  dishes  with  those  who  go 
for  ingredients  to  the  animal  world — as  vegetarians 
boast  they  can — I  fail  to  see  salvation  for  the  gouty 
gourmand  in  vegetarianism.* 

Gout,  then,  is  essentially  a  disease  of  civilisation. 

*  Since  the  above  was  written,  Mr.  Jonathan  Hutchinson,  in  his 
"Archives  of  Surgery,"  No.  I,  vol.  iii.,  has  forbidden  the  use  of 
fruit  to  all  patients  having  a  tendency  to  gout.  The  contained 
sugar  is,  of  course,  the  deleterious  agent.  The  more  sugar  a  fruit 
contain  the  more  hurtful  is  it.  Cooked  fruit  eaten  with  added 
sugar  is  specially  dangerous. 
15 


218  MARRIAGE  AND  DISEASE. 

It  is  a  condition  brought  about  by  continued  over- 
feeding and  prolonged  indolence,  and  is  consequently 
to  a  large  extent  a  disease  of  the  wealthy,  who  can 
eat  as  much  as  they  please  and  work  as  little.  In 
times  past  it  was  almost  wholly  confined  to  the  rich, 
but  in  more  recent  times  some  among  our  working- 
classes,  who  have  special  opportunities  for  feeding, 
and  whose  physical  labour  is  not  great  in  proportion, 
have  cultivated  the  disease.  At  present  gout  is  not 
at  all  uncommon  amongst  butchers,  bakers,  draymen, 
brewers,  innkeepers,  coachmen,  butlers,  publicans, 
porters,  and  others  who  eat  and  drink  largely,  and 
who  partake  sparingly  of  physical  labour. 

As  might  be  expected,  temperament  has  much 
to  do  with  the  cultivation  of  this  disease  among  a 
people.  As  a  rule,  the  large  eaters  are  the  less  active. 
They  are  capable  of  exerting  great  power  when  put 
to  it,  but  they  rarely  have  any  of  that  restless 
activity  which  keeps  the  thin  man  thin.  They  do 
not  care  much  for  the  more  volatile  preparations  of 
alcohol,  as  whisky,  which  would  induce  an  uncom- 
fortable restlessness,  but  prefer  beer  or  other  sooth- 
ing draught.  They  are  generally  largely  built  and 
have  heavy  limbs ;  even  early  in  life  they  become 
fat,  the  skin  being  oily  and  the  pores  in  it  large. 
They  have  great  powers  of  digestion,  and  to  them 
the  pleasures  of  the  table  are  of  the  first  importance. 
This  type — the  sanguine — is  the  class  most  given  to 
the  cultivation  of  gout.  It  is,  perhaps,  best  seen 
in  the  inhabitants  of  the  Midland  and  Southern 


GOUT.  219 

counties  of  England,  where  ages  of  security  and  com- 
parative prosperity  have  made  them  what  they  are ;  or 
among  the  Northern  Germans  and  the  Dutch,  whose 
pleasures  of  life  are  largely  made  up  of  eating  and 
drinking. 

There  is  no  disease  the  hereditary  character  of 
which  is  more  fully  and  generally  recognised  than 
gout ;  in  many  families  it  is  looked  upon  as  an 
heirloom.  Sir  Alfred  Garrod  said  he  could  trace 
direct  heredity  in  50  per  cent,  of  all  cases ;  Sir 
Dyce  Duckworth  gives  50  to  75  as  the  percentage 
of  cases  he  found  hereditary ;  while  Sir  0.  Scudamore 
(even  the  medical  men  who  make  a  speciality  of  the 
treatment  of  gout  become  aristocratic)  traced  direct 
heredity  in  60  per  cent,  of  all  his  cases.  Many 
observers  put  the  influence  of  family  taint  at  a  figure 
even  higher  than  any  of  the  above,  while  some  have 
gone  so  far  as  to  declare  the  disease  purely  heredi- 
tary (Dr.  Cullen).  And  probably  this  is  true  in  a 
certain  sense,  for  although  no  ancestor  may  ever 
have  actually  had  gout,  the  predisposition  may  have 
been  building  up  for  some  considerable  time.  Rarely, 
I  believe,  is  gout  built  up  in  a  single  generation, 
and  when  it  is,  it  is  not  likely  to  be  well  developed 
until  late  in  life,  hence  little  would  be  conveyed  to 
the  children.  I  think  it  is  certain  that  well-marked 
predisposition  to  gout  is  in  every  case  the  work  of 
several  generations. 

In  many  rich  families  the  disease  has  been  handed 
down  through  great  numbers  of  generations.  A 


220  MARRIAGE  AND  DISEASE. 

good  example  is  given  by  Sir  Alfred  Garrod,  who 
writes : — "  A  few  years  since,  I  was  consulted  by  a 
gentleman  labouring  under  a  severe  form  of  gout 
with  chalk-stones,  and  although  not  more  than  fifty 
years  old,  he  had  suffered  from  the  disease  for  a  long 
period.  On  inquiry,  I  ascertained  that  for  upwards 
of  four  centuries  the  eldest  son  of  the  family  had 
invariably  been  afflicted  with  gout  when  he  came 
into  possession  of  the  family  estate."  *  This  fact 
might  be  taken  as  going  strongly  to  disprove  my 
assertion  that  the  predisposition  to  gout,  like  every 
other  hereditary  pathological  character,  is  a  true 
family  degeneration.  It  might  be  argued,  that  if 
it  were  a  progressive  degeneration,  the  necessarily 
fatal  type  must  be  attained,  and  the  family  become 
extinct,  before  the  lapse  of  such  time  as  it  has  been 
known  to  run  in  families  like  that  mentioned  above ; 
and  were  gout  governed  by  the  rule  which  guides 
the  neurotic,  cancerous,  scrofulous,  and  some  other 
family  degenerations,  this  argument  would  be  good. 
In  this,  however,  gout  is  peculiar,  that  it  is  not 
nearly  so  rapidly  built  up  as  other  family  degenera- 
tions, and  consequently  is  longer  in  reaching  the 
fatal  type.  This  slowness  in  its  evolution  arises 
principally  from  two  causes,  viz.,  (i.)  The  mitigation 
it  suffers  during  the  period  of  infancy  and  youth  in 
each  generation,  and  (2.)  The  difficulty  with  which 
the  female  is  affected  by  this  form  of  degeneration. 
Gout  is  a  disease  which,  except  in  cases  where 
•  "  Gout  and  Rheumatic  Gout,"  by  A.  B.  Garrod,  M.D.,  F.RS. 


GOUT.  221 

the  family  predisposition  is  exceedingly  strong,  does 
not  make  its  appearance  until  middle  life,  or  even 
later.  There  are  instances  recorded  of  gout  appearing 
even  before  puberty,  but  such  cases  are  rare,  and 
only  occur  in  families  whose  members  have  exhibited 
the  disease  for  many  generations.  It  is  essentially 
a  cumulative  disorder,  and  the  limited,  or  rather 
natural,  feeding,  and  great  muscular  activity  of 
infancy  and  youth  in  each  generation,  so  to  speak 
reduces  the  accumulated  poison  capital,  so  that  it 
is  only  in  very  rare  cases  that  it  can  proclaim  itself, 
before  a  personal  indulgence  in  the  vicious  habits 
from  which  it  originally  sprang  gives  it  the  neces- 
sary strength.  Sir  Spencer  Wells  pointed  out,  some 
years  ago,  that  the  children  begotten  before  any 
acute  attack  of  gout  in  the  parent,  were  but  slightly 
predisposed  to  the  disease,  as  compared  with  those 
begotten  after  the  parent  had  actually  suffered  an 
attack.  Now,  as  few  fathers  develop  gout  until 
middle  life,  it  is  clear  that  many  of  their  children, 
and  especially  the  eldest,  must  receive  the  family 
taint  in  a  mitigated  form ;  and  as  such  children  are 
generally  properly  clothed  and  fed,  take  good  and 
sufficient  outdoor  exercise,  and  are  otherwise  cared 
for  hygienically,  it  is  also  clear  that  the  weak  in- 
herited taint  cannot  develop  much  until  the  vicious 
habits — also  inherited — become  a  part  of  the  routine 
of  life*  which  seldom  or  never  occurs  before  twenty 
to  thirty  years  of  age.  Thus,  we  see,  is  the  gouty 
degeneration  retarded  in  its  course  at  every  genera- 


222  MARRIAGE  AND  DISEASE. 

tion.  First,  it  is  inherited  in  a  mitigated  form  ;  and 
second,  it  is,  so  to  speak,  being  lived  down  during 
the  first  twenty-five  years  of  life.  In  the  neurotic, 
the  scrofulous,  and  some  other  hereditary  degenera- 
tions, special  opportunities  for  their  development  are 
offered  during  the  early  years  of  life,  whereas  in  gout 
the  tendency  is  materially  reduced  during  that  period. 
As  to  the  second  cause  given  above  of  the  slow 
evolution  of  gout,  viz.,  the  difficulty  in  strongly  in- 
fecting the  female  with  the  predisposition,  I  would 
venture  to  say  it  is  not  yet  clearly  understood. 
Women  certainly  do  not  subject  themselves  to  the 
same  extent  to  predisposing  causes  as  do  men.  They 
indulge  less  freely  in  the  pleasures  of  the  table, 
whether  of  luxuries  solid  or  fluid,  and  it  is  rarely  that 
their  digestive  powers  are  anything  like  equal  to  those 
of  their  male  relatives.  Yet  all  this  will  not  account 
for  the  strange  fact  of  every- day  occurrence,  that  a 
younger  daughter  of  a  family  strongly  predisposed 
to  gout,  and  whose  brothers,  elder  and  younger,  one 
after  another  develop  the  disease,  will  show  no  dis- 
position to  follow  their  example.  She  has  inherited 
the  taint,  yet  she  does  not  develop  the  disease.  So 
long  ago  as  the  time  of  Hippocrates  it  was  suggested 
that  the  catamenial  losses  experienced  by  women 
acted  as  a  safety-valve  for  the  gout  poison,  and  that 
there  is  truth  in  this  supposition  of  the  ancients  is  not 
doubted  in  the  present  day.  Unfortunately  in*  these 
later  days  woman  is  fast  losing  her  old-time  exemption 
from  this  disease.  As  she  apes  man  in  his  worst  as 


GOUT.  223 

well  as  his  best  habits  and  customs,  so  is  she  acquiring 
the  diseases  which  were  once  peculiar  to  him  because 
of  those  habits.  Now-a-days  it  is  nothing  strange  to 
find  a  woman  suffering  from  gout  in  its  most  virulent 
form,  though  happily  sufficient  of  the  old  feminine 
spirit  survives  to  make  such  a  thing  not  an  every- 
day occurrence.  Sir  A.  Garrod  says,  "  In  the  de- 
generate times  of  the  Koman  Empire,  when  women 
gave  themselves  up  to  every  kind  of  licentiousness, 
they  appear  from  Seneca's  account  to  have  become  the 
subjects  of  gout  equally  with  men."  *  What  we  shall 
ultimately  arrive  at  can  only  be  surmised,  but  it  is 
perfectly  certain  that  as  woman  approaches  man  in 
education,  occupation,  and  mode  of  life,  she  is  at  the 
same  time  acquiring  those  diseases  and  defects  which 
were  once  peculiar  to  man.  Such  diseases  as  gout 
and  general  paralysis  of  the  insane,  once  peculiar  to 
the  male,  are  becoming  more  common  among  women 
every  day.  Criminality,  too,  has  been  increasing 
steadily  among  women  in  England  during  the  past 
quarter  of  a  century  or  more.  Can  any  one  for  an 
instant  doubt  the  cause  ? 

Gout,  as  we  have  seen,  commonly  makes  its  appear- 
ance between  the  ages  of  thirty  and  fifty  years.  At 
times  it  appears  so  early  as  ten,  twelve,  or  sixteen 
years,  but  such  cases  are  rare,  and  in  nearly  every 
instance  depend  upon  strong  hereditary  taint,  occurring 
most  frequently  in  the  children  of  elderly  fathers  who 
have  suffered  repeated  attacks  of  the  disease.  When 
*  Op.  cit. 


224  MARRIAGE  AND  DISEASE. 

gout  appears  in  women,  in  the  vast  majority  of  cases 
it  is  not  until  after  the  "  change  of  life"  or  old  age, 
and  there  is  almost  invariably  a  hereditary  predis- 
position present. 

As  to  gout  being  a  constitutional  degeneration 
affecting  the  whole  system,  there  is  ample  proof.  In 
the  first  place,  almost  every  tissue  in  the  body  of  the 
person  who  has  inherited  the  gouty  diathesis  is  liable 
to  degenerative  change.  At  an  early  stage  of  the 
disease*  the  kidneys  become  unfitted  for  their  work 
because  of  disease  consequent  on  tissue  degeneration. 
The  muscular  tissue  of  the  heart  as  well  as  its  valves 
is  in  these  persons  liable  to  degenerative  change,  and 
the  tissues  of  the  blood-vessels,  great  and  small,  are 
more  or  less  diseased  in  nearly  every  case.  The  bones, 
muscles,  connective  and  cutaneous  tissues  are  also  very 
frequently  affected,  such  persons  being  liable  at  all 
times  to  inflammations  in  all  parts  of  the  body,  to  the 
formation  of  abscesses  and  to  extensive  ulcerations. 
The  disease  is  not  confined  to  any  one,  or  even  two 
or  three,  tissues  or  organs ;  the  whole  constitution  is 
deteriorated,  every  tissue  is  to  a  certain  extent  robbed 
of  its  vitality,  and  the  system  may  be  said  to  be 
"  below  par."  The  reduced  or  unhealthy  condition 
of  the  gouty  system  is  shown  in  the  high  mortality 
which  attends  ordinary  acute  diseases,  and  also  by  the 
fact  that  anything  which  tends  to  lower  still  further 
the  nervous  tone,  such  as  sexual  excesses,  severe  study, 
indigestion,  shock,  lead-poisoning,  &c.,  will  at  once 
bring  on  an  attack  of  the  acute  symptoms  of  gout  itself. 


GOUT.  225 

In  fact,  anything  requiring  expenditure  of  nervous 
energy  and  calling  upon  the  stock  of  reserve  vitality 
finds  the  account  overdrawn,  and  so  causes  a  tem- 
porary or  permanent  health  bankruptcy. 

The  degenerate  condition  of  the  gouty  parent  is 
also  marked  in  many  instances  in  his  children,  more 
especially  those  begotten  late  in  life.  These  not  seldom 
present  the  scrofulous  diathesis  more  or  less  deeply 
marked,  or,  short  of  this,  they  are  feeble  generally, 
enjoy  only  precarious  health,  and  are  short-lived. 

The  old  idea  that  the  gouty  are  specially  long- 
lived,  and  are  also  endowed  with  more  than  the 
ordinary  quantum  of  intelligence,  is  diametrically 
opposed  to  the  truth.  Certainly  some  of  the  gouty 
live  to  be  old,  but  for  every  one  who  does,  scores 
die  comparatively  young  because  of  their  inherited 
disease  tendency ;  while  against  every  gouty  one 
who  holds  a  proud  place  in  the  intellectual  world 
might  be  placed  a  crowd  of  fellow- sufferers  made  up 
of  coal-heavers,  publicans,  broken-down  butlers  and 
brewer's  men,  who  lay  no  claim  to  the  intellectual ;  or 
even  of  scions  of  noble  houses  once  known  to  fame, 
but  now,  alas !  only  forming  that  remnant  of  the 
decaying  aristocracy  which  the  democratic  reformer 
delights  in  holding  up  to  ridicule. 

The  following  history  of  a  gouty  family,  which  I 
borrow  from  Sir  Alfred  Garrod,  will  at  once  dispose 
of  the  foolish  idea  that  gout  seldom  proves  fatal,  and 
then  only  in  extreme  old  age.  He  describes  his 
patient  thus : — "  A  gentleman  forty-eight  years  of 


226  MARRIAGE  AND  DISEASE. 

age,  whose  health  has  been  good  with  the  exception 
of  attacks  of  gout,  which  commenced  at  the  age  of 
thirty-six  in  one  great  toe.  The  attacks  gradually 
became  more  frequent  and  more  prolonged,  so  that 
he  was  scarcely  ever  free  from  them."  Of  this  man's 
family  he  says  : — *  The  father  had  very  severe  gout ; 
the  mother,  when  seventy  years  of  age,  began  to 
suffer  from  it ;  he  has  had  six  brothers,  of  whom  one 
died  of  very  severe  gout,  and  was  crippled  from  chalk 
deposits  in  both  upper  and  lower  extremities ;  another 
had  severe  gout  and  chalk-stones,  and  died  of  albumi- 
nuria ;  a  third  had  gout  and  paralysis,  of  which  he 
died ;  a  fourth  had  gout,  and  died  of  erysipelas ; 
a  fifth  died  of  gout,  complicated  with  some  urinary 
affection  ;  and  a  sixth  is  alive,  but  suffers  from  gout 
in  the  same  way  as  the  patient  himself."  *  Here  Sir 
Alfred's  patient  was  only  forty-eight  years  of  age,  yet 
he  had  suffered  for  twelve  years,  and  was  "  scarcely 
ever  free  from  attacks,"  while  of  his  brothers  five  were 
dead  of  gout,  and  the  only  one  living  was  crippled 
like  himself '. 

In  those  of  the  gouty  diathesis,  death  often  occurs 
early  in  life  from  an  attack  of  some  of  the  acute 
inflammatory  disorders,  to  all  of  which  the  gouty  are 
specially  susceptible.  Later  in  life  death  is  common 
from  organic  disease  of  the  kidneys,  from  heart  disease, 
asthma,  and  apoplexy,  the  rottenness  of  the  blood- 
vessels in  the  brain  rendering  the  gouty  more  liable 
to  this  last-named  affection  than  any  other  class. 
*  Op  cit. 


GOUT.  227 

Besides  causing  apoplexy  and  paralysis,  this  diseased 
condition  of  the  blood-vessels  in  the  brain  often  causes 
mental  disorder,  not  seldom  terminating  in  complete 
dementia. 

Although  gout  seldom  attacks  the  female,  it  is 
frequently  transmitted  through  the  female  to  the 
males  of  the  next  generation ;  consequently  it  is  of 
great  importance  that  the  man  who  has  inherited  a 
predisposition  to  gout  should  not  marry  the  daughter 
of  a  gouty  family,  for  in  doing  so  he  makes  it  doubly 
certain  that  the  children  shall  inherit  the  disease  ten- 
dency, and  that  in  an  aggravated  form.  Of  course 
all  men  should  avoid  alliance  with  the  scrofulous 
and  the  rheumatic,  but  with  those*  of  the  gouty 
diathesis  such  an  alliance  is  specially  dangerous  to 
the  offspring,  who  will  probably  develop  painful  and 
deforming  diseases  of  the  bony  framework  of  the 
body. 

Again,  the  man  who  has  inherited  a  tendency  to 
gout,  besides  marrying  a  healthy  woman,  should, 
if  he  marry  at  all,  marry  young,  for  he  thereby,  as 
Sir  Spencer  Wells  has  shown,  vastly  reduces  the 
chances  of  his  children  inheriting  the  disease  tendency 
in  all  its  strength.  Indeed,  if  the  gouty  were  to 
unite  only  with  the  untainted,  and  children  were  only 
begotten  prior  to  the  outbreak  of  the  disease  in  the 
parent,  it  is  probable  that,  with  attention  to  dieting 
and  exercise,  the  disease  tendency  might  eventually 
be  eradicated,  even  in  families  where  it  has  "  run ' 
for  many  generations. 


CHAPTER  XVI. 

RHEUMATISM. 

EXCEPTING  gout,  there  is  perhaps  no  other  disease  the 
hereditary  character  of  which  is  more  generally  re- 
cognised by  the  multitude  than  rheumatism.  This 
disease,  like  gout,  appears  to  depend  upon  the  exist- 
ence in  the  system  of  certain  poisonous  matters,  but 
exactly  how  this  poison  is  produced,  or  why  it  should 
be  retained  in  the  system  in  one  individual  and  not  in 
another,  medical  science  is  not  yet  able  to  explain. 
It  is  suspected  that  some  interference  with  the  natural 
excretive  action  of  the  skin,  probably  having  a  nervous 
origin,  may  have  much  to  do  with  the  presence  of  the 
poisonous  material  within  the  system ;  but  as  to  this 
there  is  no  absolute  proof.  It  has  been  noticed  for 
ages  that  in  some  persons  checking  the  cutaneous 
action  by  severe  or  repeated  chills  favours  the  appear- 
ance of  this  disease,  and  also  that  indulgence  in 
certain  foods  and  drinks  acts  in  a  similar  manner. 
Some  believe  that  these — interference  with  the  action 
of  the  skin  and  indulgence  in  improper  food — per- 
sisted in,  aid  largely  in  building  up  in  the  healthy  the 
constitutional  condition  necessary  for  the  development 


RHEUMATISM.  229 

of  the  disease,  but  beyond  the  supposition  we  can 
hardly  at  present  go.  Why  a  chill,  which  to  one 
person  is  harmless,  should  in  another  be  followed  by 
high  fever,  swelling  of  the  joints,  excruciating  pain, 
and  later  by  disease  of  the  heart,  we  cannot  explain. 
All  we  can  say  is,  that  a  special  temperament  pre- 
disposes the  one  to  this  suffering  and  sickness,  and 
the  other  escapes  because  he  is  not  possessed  of  that 
peculiar  temperament. 

The  peculiar  temperament  here  referred  to  is 
called  the  rheumatic  diathesis,  and  it  is  hereditary. 
Authorities  agree  that  in  about  a  third  (30  per  cent.) 
of  all  cases  of  rheumatism,  hereditary  predisposition 
can  be  traced,  but  that  these  figures  represent  any- 
thing like  the  real  amount  of  hereditary  taint  existing 
among  such  cases,  I  do  not  for  a  moment  believe. 
Of  course  the  rheumatic  diathesis,  like  every  other 
pathological  character,  has  been  and  is  being  acquired 
by  certain  individuals,  and  some  of  the  cases  of  rheuma- 
tism which  turn  up  to-day  may  be  of  those  in  which 
the  necessary  abnormal  temperament  has  been  acquired 
within  the  lifetime  of  the  individual.  Still  I  cannot 
believe  that  the  acquisition  of  so  grave  and  far-reaching 
a  diathesis  as  the  rheumatic  within  one  lifetime  is 
common,  and  that  it  occurs  in  anything  like  70  per 
cent,  of  all  the  cases  of  rheumatism  at  present  met 
with,  I  deny,  and  shall  prove  to  be  untrue. 

When  observers  tell  us  they  can  trace  heredity  in 
30  per  cent,  of  all  the  cases  of  rheumatism  they  meet 
with,  what  do  they  mean  ?  Simply  this,  that  in  that 


230  MARRIAGE  AND  DISEASE. 

proportion  of  cases  they  have  discovered  that  a  parent 
or  other  near  ancestor  has  actually  suffered  from 
rheumatism.  Now  this  is  satisfactory  only  if  we 
recognise  the  rheumatic  diathesis  as  an  acquired 
diseased  condition,  transmissible  from  parent  to  child, 
but  not  transmutable.  But  if  we  recognise  this 
rheumatic  diathesis  as  a  degenerate  condition,  affect- 
ing the  whole  economy,  and  therefore  transmutable, 
which  may  appear  in  the  next  and  following  genera- 
tions unchanged,  but  which  may  in  future  generations 
be  transmuted  to  gout,  epilepsy,  scrofula,  or  insanity, 
then  I  say  such  estimate  of  its  hereditary  character  is 
misleading.  Let  us  treat  it  as  other  hereditary  de- 
generations. Is  the  child  of  the  insane  parent  who 
is  an  idiot,  an  epileptic,  or  an  instinctive  drunkard 
not  to  be  recognised  as  the  inheritor  of  the  parental 
infirmity?  Are  the  children  of  the  confirmed  epileptic, 
who  are  respectively  idiotic,  deaf-mute,  drunken,  and 
insane,  to  be  considered  free  from  the  family  taint 
because  their  degeneracy  has  not  proclaimed  itself  in 
them  by  the  identical  symptoms  found  in  the  parent  ? 
Assuredly  not.  Why  then  should  we  refuse  to  recog- 
nise hereditary  taint  in  the  victim  of  the  rheumatic 
diathesis  whose  parents  have  shown  gout  or  scrofula, 
apoplexy  or  insanity,  or  some  other  of  the  degenerate 
conditions  by  which  decay  of  the  stock  makes  itself 
known  ? 

In  the  family  history  of  a  patient  of  my  own,  which 
I  have  given  at  page  1 86  in  the  chapter  on  cancer, 
we  have  seen  how  such  apparently  diverse  symptoms 


RHEUMATISM.  231 

of  family  degeneration  as  infantile  convulsions,  suicide, 
epilepsy,  cancer,  consumption,  and  insanity  are  allied, 
and  often  spring  from  a  common  stem.  In  the  follow- 
ing family  history — also  that  of  a  patient  of  my  own 
— we  shall  see  that  rheumatism  is  no  exception  to  the 
rule  that  all  family  degenerations  are  transmutable, 
the  form  the  disease  assumes  in  the  individual  only 
proclaiming  the  organs  or  tissues  which  the  family 
blight  has  specialty  attacked  in  each  particular  case. 
Of  course  the  tendency,  more  or  less  strong  in  all 
cases,  is  to  reproduce  in  the  offspring  the  particular 
blemish  of  the  parent,  and  we  have  seen  that  in  some 
cases,  as  in  the  suicidal  impulse,  the  identical  abnor- 
mality is  often  transmitted ;  but  to  admit  hereditary 
influence  only  in  such  cases  as  this  occurs,  is  to  miss 
the  whole  lesson  taught  by  heredity. 

J.  G.  A.'s  FAMILY  HISTORY. 

Paternal  Side.  Maternal  Side. 

First      /Grandfather,  a  drunkard.  Grandmother,  " odd  " 

generation.  \  Grandmother,  normal.  Grandfather,  normal. 

; Uncle,  a  drunkard.  Uncle,  epileptic. 

Uncle,  a  drunkard.  Uncle,  rheumatic.  Totally  crippled, 

Uncle,  an  epileptic.  and  has  daughter  in  same  con- 

Father,  excitable  and  irritable.       dition. 
Uncle,  rheumatic. 
Aunt,  rheumatic. 
Mother,  died  in  asylum. 


/Daughter,  has  had  rheumatism  and  has  heart  disease. 
I  Son,  is  now  insane. 

Third       J  Son,  died  a  few  days  old  of  convulsions, 
generation. \  Son,  now  a  chronic  maniac  in  an  asylum. 

|  Daughter,   a   suicidal   melancholiac,  died  in  asylum ;   no  issue. 
V       Family  dies  with  above  stock. 

In  the  above  stock  we  have  on  the  paternal  side 
the  drunkenness  of  the  grandfather   transmitted  un- 


232  MARRIAGE  AND  DISEASE. 

changed  to  two  of  his  sons,  and  in  another  transmuted 
to  epilepsy — a  very  common  change — while  in  the 
fourth  the  family  blight  was  only  represented  by 
irritability.  On  the  maternal  side,  the  "  oddity " 
of  the  grandmother,  a  purely  neurotic  character, 
becomes  deepened  to  epilepsy  in  a  son  and  insanity 
in  a  daughter,  while  in  the  three  remaining  members 
of  the  family  the  character  of  the  degeneration  is 
transmuted  from  the  neurotic  to  the  rheumatic  dia- 
thesis, one  son  being  totally  crippled  by  the  rheu- 
matic affection,  and  having  a  daughter  already  crippled 
from  the  same  cause.  It  is  also  to  be  noticed  in  this 
family  that  the  two  neurotic  children  never  suffered 
from  rheumatism,  and  the  three  inheriting  the  rheu- 
matic diathesis  did  not  show  any  symptoms  of  the 
neurotic.  The  union  of  members  (both  neurotic) 
of  these  degenerate  families  produced  five  children, 
three  sons  and  two  daughters,  not  one  of  which 
escaped  the  family  taint.  One  escaped  the  insane 
or  neurotic  diathesis  only  to  inherit  rheumatism  of 
a  virulent  type ;  infantile  convulsions,  suicidal  melan- 
cholia and  chronic-mania  branding  the  others  as  the 
offspring  of  a  decaying  stock. 

Some  may  think  from  rheumatism  to  insanity 
rather  a  long  cry,  and  look  upon  the  appearance 
of  both  in  the  above  family  as  a  mere  coincidence ; 
but  a  very  brief  examination  of  the  facts  will  con- 
clusively prove  the  near  relationship  existing  between 
these  two  apparently  distinct  symptoms  or  forms  of 
constitutional  decay. 


RHEUMATISM.  233 

We  would  first  notice  that  it  has  been  known  for 
centuries  that  the  rheumatic  as  well  as  the  gouty 
were  themselves  specially  liable  to  mental  disorder, 
the  older  writers  correctly  pointing  out  that  the 
mental  aberration  most  frequently  took  the  form 
of  melancholia,  with  more  or  less  stupor  in  the 
rheumatic,  and  acute  mania  in  the  gouty,  and  that 
in  both  cases  it  at  times  terminated  in  hopeless 
dementia.  This  being  so,  we  are  not  surprised  to 
find  "  Rheumatic  Insanity "  and  "  Rheumatic  and 
Gouty  Insanity"  appearing  in  various  classifications 
as  recognised  varieties  of  mental  disease.  Not  only 
are  the  rheumatic  and  gouty  specially  prone  to  inflam- 
mations of  the  membranes  of  the  brain,  often  causing 
mental  disorder  which  may  become  permanent,  and 
later  in  life  to  paralysis  and  dementia  following  apo- 
plexies, and  the  deep  and  hopeless  melancholia  found 
associated  with  diseased  blood-vessels  in  the  brain ; 
but  they  are  also  liable  above  others  to  the  ordinary 
forms  of  mental  disease.  Dr.  Clouston  of  Edinburgh 
has  published  *  some  interesting  cases  of  this  rheu- 
matic insanity,  and  has  strongly  insisted  upon  the 
rheumatic  origin  of  the  mental  disorder. 

All  this,  however,  only  relates  to  those  who  have 
or  have  had  rheumatism,  and  it  still  remains  for  me 
to  show  that  not  these  only,  but  their  relatives  also, 
are  specially  liable  to  nervous  disease  having  mental 
symptoms.  I  would  trace  the  relationship  between 
the  rheumatic  and  the  neurotic  diatheses  thus : — 

*  Journal  of  Mental  Science,  July  1870. 
16 


234  MARRIAGE  AND  DISEASE. 

Between  rheumatism  and  chorea,  or  St.  Vitus's  Dance, 
a  disease  which  attacks  great  numbers  of  children 
between  the  ages  of  seven  and  fifteen,  though  not 
by  any  means  confined  to  that  period  of  life,  there 
is  a  most  remarkable  connection.  Children  who 
have  suffered  from  rheumatic  fever,  or  whose  parents 
are  rheumatic,  are  eminently  prone  to  this  disease. 
M.  See  found  that  56  per  cent,  of  all  the  cases 
of  rheumatism  admitted  into  the  Hopital  des  Enfans 
were  complicated  with  chorea,  and  the  late  Dr.  Hillier 
stated  that  in  60  per  cent,  of  his  cases  of  chorea, 
either  the  patients  themselves,  or  one  of  their  parents, 
had  been  rheumatic.  Dr.  Copland  first  pointed  out 
this  remarkable  connection  between  rheumatism  and 
chorea,  and  many  attempts  have  since  been  made 
to  explain  it.  Drs.  Kirkes  and  Hughlings  Jackson 
have  advanced  a  theory  which  is  applicable  in  some 
cases,  but  no  one  has  yet  advanced  a  theory  which  is 
applicable  to  all. 

Here,  then,  we  have  positive  evidence  of  an  intimate 
relationship  existing  between  rheumatism  and  chorea. 
Now  let  us  see  what  chorea  is.  Chorea  is  a  purely 
nervous  disease,  whose  symptoms  are  convulsive  mus- 
cular movements,  hysterical  mental  disorder,  and,  in 
chronic  cases,  permanent  impairment  of  the  intellect. 
It  generally  comes  on  suddenly,  and  when  any  cause 
is  given  by  the  child's  friends,  it  is  usually  "  fright," 
which  simply  means  that  the  child  is  of  a  nervous 
temperament.  One  writer  on  chorea  says: — "It  is 
admitted  that  in  a  large  proportion  of  cases  there 


RHEUMATISM.  235 

is  a  neuropathic  state  which  antedates  and  pre- 
disposes to  chorea.  This  state  is  often  manifested 
in  the  family  history  by  proneness  to  affections  of 
the  nervous  system,  and  in  the  individual  by  a 
highly  excitable  state  of  the  emotions,  so  that  he 
evinces  joy,  grief,  or  anger  from  slight  causes.  All 
writers  admit  that  there  is  often  an  inherited  pre- 
disposition to  chorea."  *  In  fact,  chorea  may  be  said 
to  stand  midway  between  the  rheumatic  and  the 
neurotic  diatheses.  We  have  seen  how  closely  related 
it  is  with  the  former,  and  if  we  inquire,  we  shall 
discover  that  it  is  equally  nearly  allied  on  the  other 
side  with  the  later. 

Dr.  Radcliffe  made  careful  inquiry  into  the  re- 
lationship existing  between  chorea  and  nervous  dis- 
ease generally,  and  found  that  in  56.2  per  cent,  of 
all  his  cases  of  chorea,  "  the  father,  mother,  brother, 
or  sister  had  been,  or  was  the  subject  of  one  or  other 
of  the  following  disorders : — paralysis,  epilepsy,  apo- 
plexy, hysteria,  or  insanity."  This  is  how  the  case 
stands,  then :  We  first  discover  that  in  about  60  per 
cent,  of  all  cases  of  chorea,  the  patients  themselves, 
or  their  parents,  are  rheumatic.  Next  we  discover 
that  about  the  same  percentage  of  all  patients 
suffering  from  chorea  have  had  a  father,  mother, 
brother  or  sister  who  has  shown  unmistakable  signs 
of  the  neurotic  diathesis — in  other  words,  has  actually 
suffered  from  paralysis,  epilepsy,  apoplexy,  hysteria, 
or  insanity.  And  what  does  all  this  prove  ?  Simply 
*  J.  Lewis  Smith's  "  Diseases  of  Infancy  and  Childhood." 


236  MARRIAGE  AND  DISEASE. 

that  the  rheumatic  and  neurotic  diatheses,  which  at 
first  sight  appear  distinct  and  far  removed  from  each 
other,  are  in  reality  very  closely  allied — that  they 
are,  in  fact,  interchangeable. 

Much  further  evidence  might  be  advanced  in 
support  of  this  relationship  between  the  rheumatic 
and  neurotic  diatheses,  but  I  will  only  trouble  the 
reader  with  the  following : — When  rheumatic  disease 
attacks  the  joints  with  severity,  we  call  it  rheumatic 
fever  or  acute  rheumatism ;  when  it  attacks  the 
muscles  of  the  back,  we  call  it  lumbago ;  when  it 
attacks  the  great  nerve  of  the  leg,  we  call  it  sciatica ; 
and  when  it  attacks  the  other  smaller  nerves,  we  call 
it  neuralgia.  Now  the  connection  between  severe 
neuralgia  and  insanity  has  been  pointed  out  by  scores 
of  writers,  and  neuralgia  is  looked  upon  by  the  whole 
medical  profession  as  an  unmistakable  sign  of  the 
neurotic  temperament,  yet  it  is  nothing  more  nor  less 
than  a  certain  form  of  rheumatism.  Dr.  Maudsley 
comments  on  the  relationship  existing  between  in- 
sanity, chorea,  and  neuralgia  thus  : — "  Neuralgia  in 
the  parent  may  manifest  itself  in  the  offspring  in  the 
form  of  a  tendency  to  insanity,  and  every  experienced 
physician  knows  that  if  he  meets  in  practice  with  a 
case  of  violent  neuralgia  ...  he  may  predicate  the 
existence  of  insanity  in  the  family,  with  almost  as 
great  confidence  as  if  the  patient  were  actually  insane. 
How  it  is  we  know  not,  but  so  it  is  that  a  certain 
form  of  neuralgia  owes  its  origin  mainly  to  a  neurotic 
inheritance.  Chorea,  again,  which  has  been  described 


RHEUMATISM.  237 

fancifully  as  £an  insanity  of  the  muscles,'  is  a 
nervous  disease  which  exhibits  sometimes  a  close 
relation  of  descent  to  insanity  or  epilepsy ;  and  in 
children  descended  from  families  in  which  there  has 
been  much  insanity  we  meet  occasionally  with  diseased 
phenomena  that  seem  to  be  hybrids  between  chorea 
and  epilepsy,  or  between  chorea  and  insanity,  and 
which  pass  finally  into  one  of  these  more  definite  ruts 
of  convulsive  action."  * 

I  think  I  have  now  proved  sufficiently  clearly  the 
relationship  between  rheumatic  and  nervous  disease. 

I  need  hardly  say  the  transmutability  of  all  other 
constitutional  degenerations  hereditarily  transmitted 
could  be  equally  clearly  demonstrated,  but  I  shall  not 
here  essay  the  task.  My  only  excuse  for  interpolating 
the  last  few  tedious  pages  is  the  desire  to  point  out 
how  nearly  allied  are  so  apparently  widely  separated 
degenerate  conditions  as  rheumatism  and  insanity, 
and  to  rid  the  mind  of  the  reader  of  any  lurking 
suspicion  that  the  family  histories  given  at  pages  49 
and  231,  may  be  merely  those  of  specially  unfortu- 
nate families,  in  which  the  appearance  of  several 
diseases  were  mere  coincidences,  instead  of  the  vary- 
ing signs  of  an  all-pervading  decay  in  the  family 
stock. 

Rheumatism  is  in  itself  a  most  severe  and  painful 

affection,  and  although  in  a  large  proportion  of  cases 

not  directly  fatal,   it  is  responsible  for  a  very  large 

number  of  deaths  from  heart  disease,  kidney  disease, 

*  "  Responsibility  in  Mental  Disease." 


238  MARRIAGE  AND  DISEASE. 

asthma,  apoplexy,  syncope,  dropsy,  and  various 
affections  of  the  lungs,  all  of  which  depend  upon  and 
are  secondary  to  disease  of  the  heart.  The  great 
danger  in  all  cases  of  acute  rheumatism,  and  indeed 
in  sub-acute  cases  too,  is  the  development  of  heart 
disease.  This  occurs  in  about  50  per  cent,  of  all 
cases,  and  is  generally  the  foundation  of  a  condition 
which  ultimately,  directly  or  indirectly,  destroys  the 
life  of  the  individual. 

I  may  here  remark  that  there  is  a  form  of  heart 
disease  which  "  runs  in  families,"  and  which  frequently 
appears  without  the  person  ever  having  suffered  from 
either  acute  or  sub-acute  rheumatic  attacks.  Nearly 
all  such  cases  I  attribute  to  the  action  of  the  rheu- 
matic poison  upon  the  heart.  If  the  histories  of  the 
families  in  which  this  form  of  heart  disease  occurs  be 
inquired  into,  it  will  be  found  that  rheumatism,  in- 
tractable neuralgia,  or  other  sign  of  family  decay,  such 
as  consumption  or  insanity,  is  common  in  the  stock. 
Here  is  the  history  of  such  a  family,  every  member 
of  which  was  personally  known  to  me : — Father  has 
suffered  for  many  years  from  most  intractable 
neuralgia  of  the  head  and  neck  ;  no  heart  disease. 
Mother  became  insane  at  about  sixty  years  of  age,  as 
did  her  father  ;  no  heart  disease.  There  were  five 
children  as  follows: — I.  Son,  has  grave  heart  disease; 
never  suffered  from  rheumatism ;  is  so  eccentric  that 
he  cannot  earn  his  living.  2.  Daughter,  has  grave 
disease  of  the  heart,  and  never  suffered  from  rheu- 
matism. 3.  Son,  has  been  on  the  verge  of  insanity. 


RHEUMATISM.  239 

4.  Son,  died  of  consumption  at  thirty  years  of  age ; 
and  5 .  Daughter,  eccentric ;  has  heart  disease  ;  never 
had  rheumatism. 

Eheumatism  is  so  nearly  allied  to  gout  that  some 
observers  have  insisted  upon  their  being  identical. 
Mr.  Hutchinson  has  said  : — "  Gout  is  chronic  rheu- 
matism made  special.  .  .  ,  Gout  is  probably  chronic 
rheumatism  plus  a  dietetic  derangement.  Arguments 
in  favour  of  this  view  are  found  in  tracing  the  family 
history  in  cases.  In  most  instances  of  gout,  the 
family  history  will  show  chronic  rheumatism  in  some 
members,  frequently  on  the  female  side,  the  males 
being  liable  to  the  fully  developed  gout,  with  chalky 
deposits."  *  It  is  certainly  true  that  these  two 
affections  do  often  thus  appear  in  different  members 
of  the  same  family,  yet  the  diseases  are  not  any 
more  identical  than  are  cancer  and  insanity,  which, 
as  we  have  seen,  also  frequently  appear  in  different 
members  of  the  same  family.  The  appearance  of 
rheumatism  and  gout  in  members  of  the  same  family 
is  to  be  explained  exactly  as  is  the  appearance  of 
cancer  and  insanity,  viz.,  by  the  transmutability  of 
diatheses.  Rheumatism  must  not  be  looked  upon 
as  a  vulgarised  form  of  aristocratic  gout ;  it  attacks 
all  classes  with  charming  impartiality,  and  while  it 
is  to  be  found  among  those  who  know  the  meaning 
of  hunger  and  hardship,  it  is  to  be  found  equally 
well  developed  among  those  who  have  for  generations 
been  fondled  in  the  lap  of  luxury. 

*  British  Medical  Journal,  June  2,  1877. 


240  MARRIAGE  AND  DISEASE. 

Those  of  the  rheumatic  diathesis  are  very  prone 
to  internal  inflammations — as  of  the  sac  which  holds 
the  heart,  the  membranes  of  the  brain,  the  pleuraB, 
and  later  in  life  to  disease  of  the  kidneys,  and  also 
of  the  bones,  ligaments,  and  joints,  which  frequently 
terminates  in  complete  crippling  and  great  deformity. 
Disease  of  the  great  blood-vessels  is  also  very  com- 
mon, and  not  a  few  fatal  cases  of  aneurysm  and 
other  like  diseases  have  their  origin  in  the  rheumatic 
state. 

In  the  vast  majority  of  cases  rheumatism  makes 
its  first  appearance  between  fifteen  and  thirty  years 
of  age,  but  it  may  occur  in  early  life,  and  although 
it  is  comparatively  rare  before  five,  it  occasionally 
occurs,  leaving  heart  disease  behind,  during  the  second, 
or  even  the  first,  year  of  life. 

As  to  marriage,  it  is  clear  that,  other  things  being 
equal,  the  person  having  the  rheumatic  diathesis  is 
not  as  fit  and  proper  a  candidate  for  matrimony  as 
the  person  who  is  free  from  this  taint  of  unfit- 
ness.  We  have  seen  how  it  may  be  transmuted,  in 
transmission  to  the  children,  to  chorea,  neuralgia, 
paralysis,  heart  disease,  insanity,  or  other  of  the 
symptoms  of  family  decay.  It  is  therefore  advisable 
that  those  who  wish  to  live  in  posterity  should  avoid, 
so  far  as  possible,  intermarriage  with  those  who 
themselves,  or  whose  immediate  relatives,  have  this 
diathesis  well  marked.  And  while  this  duty  devolves 
upon  the  healthy,  who  desire  their  children  to  escape 
avoidable  suffering,  as  far  as  is  possible,  it  comes 


RHEUMATISM.  241 

with  a  force  a  hundred  times  increased  upon  those 
who  have  inherited  the  same  or  any  other  degenera- 
tive diathesis.  Let  me  say  again,  that  the  marriage 
of  persons  who  have  both  inherited  the  same  disease 
tendency  vastly  increases  the  chances  of  the  children 
inheriting  the  same  tendency,  and  that  in  an  aggra- 
vated form ;  while  it  is  equally  certain  that  the 
intermarriage  of  persons  who  have  inherited  different 
disease  tendencies,  is  hardly  less  dangerous  to  the 
offspring.  Indeed  I  question  whether  this  last  is 
not  the  more  dangerous,  for  while  in  the  former  it 
is  common  for  some  of  the  children  to  escape  tbe 
family  blight,  it  is  rare  indeed  in  marriages  of  the 
latter  description  for  any  of  them  to  escape  one  or 
other  of  the  parental  tendencies  to  disease,  or  some 
combination  of  both,  more  terrible  than  either. 

Dr.  Benjamin  W.  Richardson  says  : — "  The  worst 
intermarriages  of  disease  are  those  in  which  both 
parents  are  the  inheritors  of  the  same  disease.  .  .  . 
Intermarriages  of  distinct  diseases  are  hardly  less 
dangerous.  The  intermarriage  of  cancer  and  con- 
sumption is  a  combination  specially  fraught  with 
danger.  .  .  .  The  intermarriage  of  rheumatic  with 
consumptive  disease  is  productive  of  intermediate 
maladies,  in  which  the  bony  framework  of  the  body 
is  readily  implicated.  Children  suffering  from  hip- 
joint  disease — morbus  coxarius — are  common  examples 
of  this  combination.  Hydrocephalic  children  are  fre- 
quent results  of  the  same  combination."  * 
*  "  Diseases  of  Modern  Life." 


242  MARRIAGE  AND  DISEASE. 

Of  course  Dr.  Richardson  means  diathesis,  or 
disease  tendency,  when  he  here  speaks  of  the  inter- 
marriage of  disease.  The  examples  he  gives  of  the 
result  of  the  union  of  the  rheumatic  and  consumptive 
are  what  we  might  expect ;  the  rheumatic  condition 
having  more  or  less  devitalised  the  bones,  joints, 
and  connective  tissues  generally,  these  structures  are 
naturally  seized  upon  by  the  scrofulous  disease  germs 
as  the  most  vulnerable  point  of  attack. 


CHAPTER  XVII. 

EARLY  MARRIAGES  :    THEIR  EFFECT'UPON  THE  CHILDREN. 

"  The  young  man  who  marries  before  his  beard  is  fully  grown, 
breaks  a  law  of  nature  and  sins  against  posterity." — T.  S.  CLOUSTON, 
M.D. 

THIS  is  a  matter  of  grave  importance  alike  to  the 
moralist,  the  economist,  and  the  physiologist.  I  do 
not  purpose  here  touching  upon  it  from  a  social  or 
economic  point  of  view.  That  aspect  of  the  question 
I  leave  for  the  consideration  of  the  social  reformer,  who 
will  have  difficulty  in  discovering  a  field  in  which  his 
energies  may  be  more  profitably  expended.  Few  will 
deserve  better  of  their  country  than  he  who  succeeds 
in  staying  to  any  appreciable  extent  the  reckless  rush 
of  precocious,  ill-developed  children  into  matrimony 
which  is  at  present  going  on  among  our  people. 

This  question  of  early  marriages  was  brought  before 
the  London  Diocesan  Conference  in  1889,  and  it  was 
then  agreed  on  all  hands  that  the  evil  had  grown 
to  such  an  extent  as  to  render  some  reform  in  the 
marriage  laws  urgently  necessary.  Before  and  since 
that  time  the  matter  has  frequently  been  under  con- 
sideration by  various  organisations,  but  up  to  the 


244  MARRIAGE  AND  DISEASE. 

present  nothing  has  been  done  to  alter  the  law  which 
permits  boys  and  girls,  however  sickly  and  ill-deve- 
loped, undertaking  the  most  important  duty  which 
falls  upon  the  citizen,  viz.,  the  renewing  of  the 
population. 

The  marriage  contract  is  by  far  the  most  impor- 
tant transaction  which  the  ordinary  citizen  enters  into 
during  the  course  of  his  or  her  natural  life — important 
alike  to  the  individual  and  to  the  state ;  yet  according 
to  the  law  as  it  at  present  stands,  the  minor,  who  is 
not  incapacitated  by  idiocy  or  raving  madness,  can  at 
almost  any  age  become  a  party  to  a  contract  of  this 
nature  which  shall  be  binding  during  the  remainder 
of  his  or  her  natural  life.  That  this  is  a  grave  mistake 
I  think  all  who  seriously  consider  the  subject  must 
agree.  In  ordinary  contracts,  unless  the  thing  con- 
tracted for  can  be  proved  to  be  "a  necessary,"  the 
minor  can  in  almost  every  case  successfully  plead  his 
minority  at  the  date  of  contract  as  voiding  the  engage- 
ment. Yet  in  the  case  of  the  marriage  contract, 
where  the  thing  contracted  for  can  never  by  any 
possibility  be  a  "  necessary,"  and  where  the  lifelong 
happiness  of  two  persons  and  the  well-being  of  a 
possible  family  are  involved,  the  under-age  contractor 
can  get  no  relief,  however  designing  and  untruthful  the 
other  party  to  the  contract  may  have  been. 

In  this  question  of  child-marriage  the  moralist  and 
the  economist  both  consider  themselves  injured  parties, 
but  neither  the  one  nor  the  other  has  a  tithe  of  the 
solid  ground  for  complaint  that  the  physiologist  has. 


EARLY  MARRIAGES.  245 

Arguments,  plausible  if  unsound,  might  be  advanced 
tending  to  show  that  early  marriages  make  for  morality, 
and  something  might  also  be  said  in  answer  to  the 
objections  of  the  economist ;  but  there  is  not  a  single 
word  to  be  spoken  in  mitigation  of  the  sweeping  con- 
demnation which  the  physiologist  is  compelled  to  pro- 
nounce upon  all  marriages  of  the  immature  and  the 
senile. 

To  the  superficial  observer  it  may  appear  that  every 
marriage  must  enrich  the  state,  and  that  early  mar- 
riages must  lessen  the  amount  of  sexual  immorality, 
but  inquiry  will  prove  conclusively  how  fallacious  are 
those  views. 

Early  marriages  certainly  tend  to  the  production  of 
large  families,  but  then  a  family,  to  be  a  source  of 
wealth  to  the  state,  must  at  least  be  self-supporting, 
which  is  exactly  what  the  feeble,  degenerate  children 
of  the  great  mass  of  our  early  marriages  are  not. 
They  are  brought  forth  ill-developed  and  unhealthy ; 
their  immature,  improvident  parents  are  unable  to 
either  feed  or  educate  them  as  they  ought  to  be  fed 
and  educated ;  hence,  instead  of  being  a  source  of 
wealth  to  the  state,  they  prove  a  serious  drain  upon 
her  resources.  A  large  percentage  of  these  miserable 
children  succumb  during  infancy,  but  a  great  number 
drag  out  a  pitiful  existence,  only  to  become  inmates 
of  our  workhouses  and  infirmaries,  our  asylums  and 
prisons,  and,  after  being  supported  at  the  public  ex- 
pense for  a  longer  or  shorter  period,  to  die  prematurely, 
leaving  the  state  poorer  than  they  found  it  and  no 


246  MARRIAGE  AND  DISEASE. 

better.  It  is  indeed  a  small  percentage  of  the  children 
of  the  immature  that  ever  become  robust,  useful,  self- 
supporting  citizens. 

Again,  can  any  one  who  looks  beyond  the  immediate 
present  seriously  argue  that  morality  can  possibly  be 
the  gainer  from  such  marriages  as  those  under  re- 
view ?  Who  will  venture  to  say  that  the  immorality 
which  might  possibly  be  indulged  in  by  the  individual 
during  his  minority  because  of  his  unmarried  state  can 
approach  that  which  must  be  the  natural  outcome  of 
the  presence  in  society  of  his  half-dozen  ill-developed, 
half-educated,  half-starved  children  ?  Where  do  im- 
morality and  vice  assume  their  most  hideous  forms  ? 
Is  it  not  in  the  dens  where  the  wretched  children  of 
these  immature,  improvident,  and  impoverished  parents 
are  huddled  together  in  the  slums  of  our  great  centres 
of  population  ?  But  now  I  am  encroaching  upon  the 
domain  of  the  sociologist,  a  thing  I  promised  not  to 
do,  and  an  aspect  of  the  question  with  which  I  am  not 
competent  to  deal.  Let  us  at  once,  then,  and  briefly, 
consider  the  matter  from  the  standpoint  of  the  physio- 
logist, and  learn  how  these  early  marriages  affect  the 
standard  of  health  and  the  vitality  of  the  community. 

It  is  impossible  that  individuals,  male  or  female, 
who  have  not  themselves  reached  maturity,  can  beget 
or  bring  forth  a  fully  developed,  healthy  offspring. 
The  child  has  only  that  quantum  of  vitality  which  has 
been  conferred  upon  it  by  its  parents,  and  should  they 
be  deficient  in  vital  power,  of  necessity  so  also  must 
be  the  child.  The  deficiency  of  vital  energy  in  the 


EARLY  MARRIAGES.  247 

parent  or  parents  may  arise  from  various  causes.  It 
may  have  been  lost  from  exhausting  disease,  from 
vicious  excesses,  from  approaching  senility,  or  it  may 
never  have  been  had  to  lose,  as  is  the  case  in  the 
immature ;  but  whether  never  possessed,  or  from  what- 
ever cause  lost,  its  absence  in  the  parent  is  equally 
serious  to  the  child.  That  which  the  parent  has  not, 
he  cannot  entail  upon  his  children.  The  children  of 
the  immature  lad,  the  enfeebled  invalid,  and  the 
worn-out  roue  are  of  necessity  born  into  the  same  low 
grade  of  vital  poverty. 

From  very  early  times  it  has  been  noted,  of  man 
and  animals  alike,  that  the  young  begotten  or  brought 
forth  by  the  immature  has  been  wanting  to  a  greater 
or  less  extent  in  strength,  stamina,  and  courage — in 
general  development,  in  fact.  No  breeder  of  stock 
would  permit  his  mares,  heifers,  or  ewes,  however 
healthy,  to  bring  forth  young  before  they  had  arrived 
at  maturity,  nor  would  he  permit  an  immature  male 
to  impregnate  the  females  of  his  herds  or  flocks. 
When  such  does  occur,  the  offspring  is  invariably 
small,  weedy,  and  not  worth  the  trouble  its  bringing 
up  entails.  "  The  young  of  animals  not  yet  fully 
developed  are  small  and  stunted,  incapable  of  perfec- 
tion :  it  is  observed  in  foals,  lambs,  goats,  calves,  &c., 
born  of  very  young  parents ;  they  remain  weak,  lym- 
phatic, and  functionally  inert."  *  Here  is  a  case  in 
point  which  recently  came  under  my  own  observation. 
A  young  sow  was  impregnated  by  a  mature  boar,  and 
*  "  A  Physician's  Problems,"  by  Charles  Elam,  M.D. 


248  MARRIAGE  AND  DISEASE. 

when  eleven  months  old  brought  forth  seven  pigs. 
They  were  tiny,  ill-developed  things  ;  some  died  im- 
mediately after  birth,  others  within  a  few  days,  and 
all  of  them  succumbed  within  five  weeks  of  the  time 
of  birth.  The  strength  of  the  mother  was  consider- 
ably taxed  by  the  operation,  but  she  recovered,  and 
having  gained  maturity,  she  had  well-developed  and 
healthy  offspring  by  the  same  father.  It  is  a  common 
practice  in  many  districts  to  destroy  the  first  litter  of 
puppies  brought  forth  by  a  bitch,  and  if  you  ask  the 
"  fancier "  why  he  does  so,  he  will  inform  you  that 
"  the  first  litter  are  never  any  good ;  they  are  sickly, 
and  seldom  get  through  the  distemper ;  they  have  no 
pluck,  and  they  never  come  to  anything." 

In  the  human  family  the  same  rule  holds  good. 
The  children  born  of  parents  who  have  not  themselves 
reached  maturity  are  markedly  inferior  to  those  born 
under  like  circumstances  of  mature  parents.  Aristotle 
remarked  that  in  those  cities  of  Greece  where  it  was 
the  custom  for  young  people  to  marry  before  maturity, 
the  children  were  puny  and  of  small  stature.  Montes- 
quieu observed  the  same  fact  when,  in  France,  the  fear 
of  conscription  induced  great  numbers  of  young  people 
to  marry  long  before  the  proper  period :  the  unions 
were  fruitful,  but  the  children  were  small,  wretched, 
and  unhealthy.  According  to  M.  Lucas,  the  same 
occurred  in  1 8 1 2  and  1813. 

A  vast  number  of  these  children  of  the  immature 
are  born  prematurely,  to  the  great  danger  of  the  im- 
perfectly developed  mothers;  a  much  larger  percentage 


EARLY  MARRIAGES.  249 

of  them  are  idiotic,  dumb,  blind,  scrofulous,  and  other- 
wise imperfect  and  deformed  than  the  children  of 
parents  generally ;  they  have  a  less  firm  hold  on  life 
than  the  children  of  mature  parentage,  and  many 
succumb  to  scrofulous  and  nervous  affections,  a  great 
number  dying  of  convulsions  before  or  during  the 
period  of  the  first  dentition.  As  a  class,  such  chil- 
dren are  decidedly  not  long-lived,  and  those  who  do 
attain  the  age  of  maturity  are  generally  delicate  and 
under-sized  physically,  often  obtuse,  and  more  or 
less  dwarfed  mentally,  if  not  distorted  at  least  blunted 
morally,  and  are  wanting  in  spirit,  energy,  and 
courage. 

This  last  mentioned  trait — lack  of  courage — is 
peculiarly  characteristic  of  the  offspring  of  immature 
parents,  as  well  in  the  human  family  as  in  the  brute 
creation.  For  instance,  dogs  the  offspring  of  immature 
parents,  whatever  the  ferocity  of  the  breed,  are  timid, 
fearful  creatures,  that  can  be  taught  nothing ;  spirit- 
less curs,  that  are  absolutely  worthless,  and  are  as  a 
consequence  but  rarely  permitted  to  long  survive  their 
birth.  In  the  human  family  this  want  of  courage  has 
always  been  recognised  as  a  failing  of  children  of 
immature  parentage.  To  be  called  the  "  son  of  a  boy  " 
or  the  "  child  of  a  girl "  is  synonymous  with  being 
called  a  coward.  Thus  Shakespeare,  who  knew  some- 
thing of  everything,  makes  Macbeth  exclaim  when 
addressing  Banquo's  ghost : — 

"  What  man  dare,  I  dare. 
Approach  thou  like  the  rugged  Russian  bear, 
17 


250  MARRIAGE  AND  DISEASE. 

The  armed  rhinoceros,  or  the  Hyrcan  tiger, 
Take  any  shape  but  that,  and  my  firm  nerves 
Shall  never  tremble  :  or,  be  alive  again, 
And  dare  me  to  the  desert  with  thy  sword  ; 
If  trembling  I  inhibit  thee,  protest  me 
The  baby  of  a  girl."  * 

This  absence  of  courage  and  virility  in  the  children 
of  the  immature  is  well  illustrated  in  the  result  of 
Marro's  investigations.  He  found  that  an  astonish- 
ingly large  percentage  of  the  insane  and  thieves  were 
the  children  of  immature  fathers,  while  the  same 
class  was  but  poorly  represented  among  murderers 
and  sexual  offenders,  where  courage  or  ferocity  and 
animal  vigour  were  necessary  (vide  page  262). 

Authorities  are  unanimous  in  agreeing  that  the 
children  of  mothers  under  twenty,  and  of  fathers 
under  twenty-four,  are,  as  a  class,  less  robust  mentally, 
morally,  and  physically,  than  children  of  parents  in 
their  prime.  M.  Joseph  Korosi,  of  the  Buda-Pesth 
Statistical  Bureau,  has  made  more  extensive  inquiries 
upon  this  subject  than  any  other  investigator,  and 
his  conclusions  agree  closely  with  those  of  Marro 
and  others,  viz.,  that  immature  parents  bring  forth 
a  degenerate  stock,  in  which  the  percentage  of 
idiots,  cripples,  insane,  consumptives,  criminals,  &c., 
is  immensely  larger  than  in  the  children  of  mature 
parents.  The  most  perfect,  robust,  and  long-lived 
children  are  those  of  fathers  between  twenty-five  and 
forty,  and  of  mothers  between  twenty  and  thirty  years. 

The  late  Dr.  J.  Matthews  Duncan,  who  enumerated 
*  "  Macbeth,"  Act  III.  Scene  iv. 


EARLY  MARRIAGES.  251 

among  the  evils  arising  from  premature  marriages 
"  abortions,  early  death  of  children,  excessive  families, 
twins,  triplets,  idiots,  and  sterility,"  says : — "  In 
woman  the  age  of  maturity  is  twenty  to  twenty- 
five  ;  in  men  it  is  later,  probably  by  at  least  five 
years;  and  you  will  pardon  the  interpolation  here 
of  the  reflection,  well  worthy  of  being  fully  dwelt 
on,  that  this  late  ascertained  physiological  law  tallies 
with  the  old  and  wisest  counsels  as  to  the  nubility 
of  men  and  women — a  part  of  the  grand  subject  of 
morals  and  medicine.  At  this  age  a  woman  has  the 
lowest  risk  of  sterility,  the  greatest  likelihood  of 
having  healthy  children  that  will  long  survive,  the 
greatest  likelihood  of  herself  surviving  childbirth,  the 
lowest  risk  of  having  abortions,  of  having  excessive 
family,  of  having  plural  pregnancy,  and  of  bringing 
forth  idiots."  * 

Even  the  children  of  healthy  and  well-fed  boys 
and  girls  of  the  better  classes  are  decidedly  inferior 
to  the  children  of  mature  parents.  That  has  been 
proven.  What,  then,  must  we  expect  from  the  pre- 
mature marriages  of  the  stunted,  pale-faced  boys 
and  girls  of  our  great  cities  ?  In  them  the  deteri- 
orating influences  of  city  life  have  produced  a  class 
largely  lacking  in  vitality — a  class  which  is,  as  we 
have  seen,  actually  in  process  of  decay,  and  which, 
even  at  its  best,  could  not  produce  an  offspring 
with  the  normal  quantum  of  vital  energy.  Yet  this 
is  the  very  class  among  which  we  find  premature 
*  Lancet,  March  23,  1889. 


252  MARRIAGE  AND  DISEASE. 

marriages  most  common.  The  pale,  wan,  sad-eyed 
factory-hand,  or  other  city  toiler  of  either  sex,  with- 
out a  single  penny  put  past  for  the  rainy  day,  at 
any  age  from  twelve  and  fourteen  upwards,  under- 
takes all  the  cares  and  responsibilities  of  the  married 
state,  with  a  lightness  of  heart  which  can  only  arise 
from  ignorance  or  carelessness,  or  both.  To  these 
children,  children  are  born,  two-thirds  of  whom, 
happily,  die  in  infancy,  while  the  other  third  live 
a  charge  upon  their  fellows.  No  doubt  can  exist 
that  these  child  marriages  take  almost  equal  rank 
with  want  of  fresh  air  and  sunlight,  poverty  and 
drunkenness,  as  agents  in  the  production  of  that 
general  deterioration  and  decay,  which  exterminate 
our  poor  city  dwellers  within  three  or  four  genera- 
tions. 

According  to  the  last  Annual  Report  of  the  Eegistrar- 
General,  there  were  during  the  year  1889,  94,040 
men  of  twenty-one  and  under,  married.  Of  these, 
80,905  had  gained  their  majority,  8769  were  twenty 
years  of  age,  3576  were  nineteen,  728  were  lads  of 
eighteen,  59  and  3  were  boys  of  seventeen  and  six- 
teen respectively.  On  turning  to  the  women,  we  find 
that  no  less  than  42,170  were  married  of  twenty 
years  of  age  and  under.  Of  these,  only  19,223  were 
twenty,  14,129  were  nineteen,  7159  were  eighteen, 
1472  were  seventeen,  167  were  sixteen,  and  20 
were  fifteen.*  But  this  is  not  the  worst.  Had 

*  In  1888  two  brides  were  fourteen,  and  one  had  reached  the 
wifely  age  of  thirteen  years. 


EARLY  MARRIAGES.  253 

these  immature  persons  married  robust  individuals  of 
mature  age,  the  result  would  have  been  much  less 

D      ' 

injurious  to  posterity  than  it  will  be,  for  the  union 
of  an  immature  with  a  mature  parent  is  decidedly 
less  injurious  to  the  offspring  than  the  union  of  the 
immature  with  the  immature.  Upon  analysis,  how- 
ever, we  discover  that  33,526  lads  of  twenty-one  to 
sixteen  years  of  age  married  wives  of  twenty  to 
fifteen  years  old,  and  that  33,526  girls  of  twenty 
to  fifteen  years  of  age  took  for  husbands  lads  of 
twenty-one  to  sixteen  years  old.  Now  if  we  remember 
that  the  vast  majority  of  these  boy  "and  girl  husbands 
and  wives  belonged  to  the  working-classes,  and  that 
the  greater  number  of  them  sprang  from  the  ill- 
developed,  prematurely  decrepit  city  dwellers  we  have 
been  speaking  of,  we  shall  get  some  idea  of  what 
suffering  and  poverty  these  premature  unions  caused, 
what  child-death  they  represented,  and  what  a  source 
of  contamination  they  must  prove  to  the  health  of  the 
people. 

But  why,  it  will  be  asked,  should  these  thoughtless, 
improvident  boys  and  girls  be  permitted  to  marry  ? 
According  to  the  recent  Criminal  Law  Amendment 
Act,  no  girl  under  sixteen  can  consent  to  illicit  sexual 
indulgence ;  her  consent  in  no  way  mitigates  the 
offence  of  the  man  who  knows  her  carnally.  Now, 
if  her  consent  to  illicit  intercourse  be  worthless,  of 
whafc  value  can  be  her  consent  to  marriage  ?  It  may 
be  argued  that  in  the  case  of  marriage  the  child  is 
guided  by  the  wise  counsels  of  parents  or  guardians, 


254  MARRIAGE  AND  DISEASE. 

but  we  know  as  a  matter  of  fact  that  the  advice  of 
parents  is  not  by  any  means  invariably  wise  when  the 
marriage  of  their  children,  old  or  young,  is  in  ques- 
tion, and  also  that  most  of  the  marriages  entered  into 
by  girls  under  sixteen  are  contracted  against  the  advice 
and  wishes  of,  and  too  often  without  the  knowledge  of, 
the  parents  of  the  girl.  Assuredly  if  a  girl  of  sixteen 
be  unable  to  choose  upon  whom  she  shall  bestow  her 
favours  temporarily,  she  should  be  deemed  unable  to 
choose  a  partner  for  life,  or  to  delegate  to  another  so 
momentous  a  duty. 

Now  that  the  ecclesiastical  element  forms  no 
necessary  part  of  the  wedding  ceremony,  and  the 
marriage  bond  has  become  a  mere  civil  contract  in 
the  eye  of  the  law,  it  is  difficult  to  see  why  a  girl  of 
twelve,  thirteen,  or  fourteen  years  of  age  should  be 
able  to  enter  into  a  life-long  contract  of  a  sexual 
nature,  and  at  the  same  time  be  unable  to  enter  into 
a  temporary  contract  of  a  similar  kind.  If  the  law 
denies  her  the  right  in  the  one  case,  it  should  deny 
her  the  right  in  the  other.  If  she  be  unable  to 
choose  a  lover,  as  she  most  certainly  is,  she  is  unable 
to  choose  a  husband,  and  no  hardship  could  possibly 
arise  from  forbidding  her  the  right.  At  present  the 
ages  at  which  the  marriage  contract  can  be  legally 
entered  into  are  (i  Jac.,  c.  i)  twelve  and  fourteen  for 
girls  and  boys  respectively,  which  is  absurd  consider- 
ing how  imperfectly  developed  children  are  at  those 
ages  in  these  countries.  I  do  not  suppose  any  one 
would  seriously  object  if  it  were  enacted  that  girls 


EARLY  MARRIAGES.  255 

under  eighteen  and  lads  under  twenty  could  not  legally 
make  a  binding  marriage  contract.  If  such  a  law  were 
established  and  could  be  effectually  carried  out,  it 
would  raise  the  standard  of  morality  among  the  lower 
ranks  of  society,  reduce  appreciably  the  grinding 
poverty  and  overcrowding  in  the  industrial  centres, 
and  materially  increase  the  average  vital  capacity  of 
our  people. 


CHAPTER  XVIII. 

LATE   MARRIAGES  I    THEIR    EFFECT  UPON  THE    CHILDREN. 
"  Filii  ex  senibus  nati,  raro  sunt  firmi  temperamenti." 

— SCOLTZIUS. 

DR.  MARRO  fixes  tlie  period  of  decadence  in  fathers 
at  from  forty  years  onward.  M.  Korosi,  after  inquiry 
in  24,000  cases,  says  above  forty,  fathers  tend  to 
beget  weak  children.  The  most  healthy  children  have 
mothers  below  the  age  of  thirty-five.  During  the  year 
1889  no  fewer  than  11,516  men  of  forty- five  to 
upwards  of  eighty-five  years  of  age  were  married, 
and  11,148  women  of  forty  to  eighty  years  became 
wives  in  England  and  Wales.  Of  these  wives  3,472 
were  fifty  or  more  years  of  age,  and  from  these  pos- 
terity will  suffer  small  injury.  But  the  marriage  of 
the  remaining  7,676  women  of  between  forty  and 
fifty,  and  11,516  men  already  some  way  on  the  down- 
ward path  to  decay,  must  have  a  great  and  gravely 
injurious  effect  upon  the  generation  in  which  their 
offspring  shall  appear. 

Just  as  the  immature  parent  who  has  not  reached 
perfect  development  produces  a  degenerate  offspring, 
so  the  elderly  parent,  the  tide  of  whose  vitality  is 
on  the  ebb,  brings  forth  children  more  or  less 


LATE  MARRIAGES.  257 

imperfect  in  mind  and  body.  And  the  further  the 
vital  tide  has  receded  in  the  parent,  the  farther 
removed  from  the  high-water  mark  of  perfection 
will  be  the  children. 

I  have  said,  in  the  preceding  chapter,  that  whether 
the  lack  of  vitality  in  the  parent  or  parents  arises 
from  immaturity,  disease,  exhaustion,  or  old  age, 
the  effect  upon  the  offspring  is  the  same.  This  is 
true,  yet  it  is  not  the  whole  truth.  The  late  Dr. 
Griesinger  of  Berlin,  speaking  of  idiocy,  says: — "  In 
families  where  epilepsy,  mental  disease,  paralytic 
affections,  deaf-dumbness  are  frequent,  idiocy  is  also 
observed  to  be  common.  Frequently  it  occurs  as  a 
mere  partial  phenomenon,  as  an  individual  manifes- 
tation of  a  general  degeneration  of  the  race :  thus 
we  see,  in  a  number  of  brothers  and  sisters,  one  or 
two  idiots,  together  with  others  who  are  small,  in- 
completely developed,  ugly,  and  sterile.  These  de- 
generations are  observed  in  families  .  .  .  where  the 
parents  have  been  too  old  or  too  young."*  Here 
the  children  of  the  immature  and  the  senile  are 
classed  together,  as  is  usual.  They  have  much  in 
common.  Both  are  sadly  wanting  in  vital  power 
and  in  perfection  of  development,  physical,  mental, 
and  moral.  Hence  we  have  a  vastly  greater  percent- 
age of  idiots,  deaf-mutes,  insane,  epileptics,  thieves, 
cripples,  dwarfs,  drunkards,  and  sterile  individuals 
among  both  classes  than  we  can  discover  among  the 
children  of  mature  parentage.  But  although  they 
*  "  Mental  Pathology  and  Therapeutics,"  Syd.  Soc. 


OF   THE 

UNIVERSITY 

OF 


258  MARRIAGE  AND  DISEASE. 

have  all  these  and  other  imperfections  in  common, 
there  are  many  points  of  difference  which,  if  not  of 
very  great  practical  importance,  are  deeply  interesting. 
Let  us  briefly  consider  some  of  these. 

In  the  first  place,  although  early  death  is  much 
more  common  among  both  these  classes  than  among 
ordinary  children,  there  is  not  the  same  terrible 
mortality  during  the  first  year  of  life  among  the 
children  of  the  senile  that  occurs  in  those  of  the 
immature.  A  much  larger  proportion  of  the  former 
live  to  years  of  maturity,  although  they  seldom  or 
never  reach  old  age.  Indeed,  they  may  be  said  to 
be  old  from  their  birth,  for  they  have  many  of  the 
characteristics  of  the  aged  while  still  children. 
Prosper  Lucas*  and  other  writers  have  given  some 
remarkable  descriptions  of  the  aged  aspect  of  such 
children. 

Another  most  interesting  and  curious  difference 
is,  that  whereas  both  are  specially  prone  to  mental 
imperfection,  the  insanity  or  mental  distortion  does 
not  take  the  same  form  with  equal  frequency  in 
the  two  classes.  Thus  among  the  offspring  of  the 
immature,  we  find  blank  idiocy  very  much  more 
common  than  among  that  of  senile  parentage.  Among 
the  latter,  congenital  mental  defect  is  very  common 
also,  but  it  does  not  nearly  so  often  take  the  form 
of  utter  vacuity  as  it  does  in  the  former.  In  the 
one  case  you  generally  find  blank  idiocy,  accompanied, 
it  may  be,  with  deaf-mutism,  blindness,  epilepsy,  or 

*  "  Trait^  philosophique  et  physiologic^  de  l'H6r6dit6  naturelL" 


LATE  MARRIAGES.  259 

some  such  bodily  imperfection  as  squint,  paralysis, 
cleft-palate,  &c.,  while  in  the  other,  the  young  of 
the  senile,  you  do  not  meet  with  the  same  complete 
absence  of  mental  power,  nor  the  same  amount  of 
such  deformities  as  club-foot,  cleft-palate,  paralysis, 
squint,  blindness,  &c. 

The  distinctive  characteristics  of  the  two  classes 
might  be  roughly  summed  up  as  follows: — The 
children  of  immature  parentage  are  specially  liable 
to  death  during  infancy  from  wasting,  scrofulous,  and 
convulsive  affections.  They  are  liable  in  a  remark- 
able degree  to  idiocy  and  imbecility  of  a  low  type, 
and  to  physical  deformities  and  imperfections.  Large 
numbers  of  them  succumb  to  tubercular  disease  about 
the  ages  of  puberty  and  adolescence,  and  few  of  them 
attain  even  advanced  middle  age.  The  genital  organs 
are  ill-developed  and  often  deformed,  and  a  great 
number  of  them  are  sterile.  They  are  also  notorious 
for  their  lack  of  energy  and  courage.  Hence  the 
class  of  criminals  to  which  they  give  the  greatest 
number  of  recruits  is  that  of  thieves  and  other  petty 
offenders. 

The  children  of  the  senile  are  as  a  class  ngly,  small 
of  stature  and  stooping,  which,  together  with  the 
absence  of  subcutaneous  fat,  gives  them  a  look  of 
old  age  while  still  young.  Idiocy  is  less  common 
amongst  them  than  weak-mindedness  amounting  to 
imbecility,  which  is  often  accompanied  with  more  or 
less  perversion  of  moral  feeling,  and  a  plentiful  supply 
of  deep  low  cunning.  Many  of  them  die  between 


260  MARRIAGE  AND  DISEASE. 

the  ages  of  puberty  and  adolescence  of  tubercular 
disease,  few  of  them  live  past  middle  age,  and  great 
numbers  of  them  ultimately  become  insane  and 
criminal.  They  are  nervous,  irritable,  passionate,  and 
horribly  cruel,  and  are  the  perpetrators  of  most  of 
those  fiendish  barbarities,  the  recital  of  which  from 
time  to  time  shocks  the  civilised  world. 

To  put  it  shortly,  the  children  in  each  case  are 
like  their  parents.  The  immature  parent  is  only 
partially  developed  mentally  and  bodily,  and  like  him 
his  child  is  wanting  both  in  mind  and  body.  On 
the  other  hand,  the  aged  parent,  though  deficient 
in  physical  vigour,  is  often  ripe  mentally — for  the 
mental  faculties  flourish  long  after  the  bodily  vigour 
has  begun  to  wane.  Consequently,  we  find  in  his 
children  mental  ability  curiously  mixed  with  that 
peevish  irritability  so  typical  of  the  aged,  and  dis- 
torted as  we  should  expect  to  find  it  imprisoned  in  a 
prematurely  decrepit  physical  organisation. 

This  I  draw  from  my  own  observation  and  experi- 
ence after  many  years'  intimate  association  with  large 
numbers  of  the  idiotic,  imbecile,  and  insane,  and 
their  relatives,  together  with  some  study  of  those 
brought  before  our  criminal  courts  for  judgment. 
Unfortunately  I  cannot  present  statistics  of  my  own 
on  the  subject,  but  am  convinced  that  if  I  could  they 
would  support  the  views  here  broadly  expressed,  as 
do  the  admirably  arranged  figures  of  such  eminent 
investigators  as  Marro,  Langdon  Down,  and  Korosi. 

A  glance  at   the  accompanying  diagram    which  I 


LATE  MARRIAGES.  261 

take  from  Mr.  Havelock  Ellis's  excellent  work  "  The 
Criminal,"  *  will  show  how  far  the  inquiries  of  Dr. 
Marro  go  to  support  the  views  expressed  above. 

This  plate  shows  the  ages  of  the  fathers  at  the 
period  of  conception  of  criminals  as  compared  with 
ordinary  persons  and  with  the  insane.  Marro  divided 
the  fathers  into  three  groups,  viz. :  (i)  the  immature, 
to  which  he  considered  all  under  25  years  of  age  to 
belong ;  (2)  those  of  the  period  of  maturity,  which  he 
put  down  as  from  26  to  40  ;  and  (3)  those  in  the  period 
of  decadence,  which  included  all  fathers  over  40  years 
of  age  at  the  time  the  child  was  conceived.  In  the 
plate  the  first  column  in  each  group  represents  the 
proportion  of  the  children  of  immature  parents,  the 
central  column  those  of  mature  fathers,  and  the  last 
the  proportion  of  those  of  decrepit  fathers. 

The  first  thing  impressed  upon  us  by  this  plate,  is 
the  fact  that  "  Criminals  in  general "  are  midway 
between  ordinary  persons  and  the  insane  as  regards 
healthy  .parentage.  The  percentage  of  persons  of 
mature  parentage  among  normal  persons  is  66.1,  this 
is  reduced  in  the  criminal  class  to  56.7,  and  again 
in  the  insane  to  4/.O ;  each  of  these  decreases 
being  accompanied  by  a  corresponding  increase  of 
those  of  immature  or  senile  ancestry,  or  both. 

In  the  next  place,  we  notice  that  the  children  of 

immature  fathers  are   but   poorly  represented  among 

murderers,  sexual  offenders,  and  sharpers,  which  goes 

to  corroborate  my  assertion  that  they  are  wanting  in 

*  "  The  Contemporary  Science  Series."    Walter  Scott. 


262 


MARRIAGE  AND  DISEASE. 


Diagram  showing  Proportion  of  Immature,  Mature,  and  Senile 
Parentage  in  Normal  Persons,  the  Insane,  and  Criminals. 


Normal 

Sexual 

i'erso 

113 

Off 

en< 

lers. 

Criminals 
in 
General. 

She 

Thieves. 

irp 

jrs. 

Murderers. 

— 

— 

In 

sane. 

- 

r 

r 

— 

r 

— 

d  |  I        «   J  I        £|    d 

in    v>k    rx           w     O     t*- 

H      10     M                      IQ     « 

000 

LATE  MARRIAGES.  263 

courage,  ferocity,  animal  vigour,  and  mental  power 
generally.  On  the  other  hand,  they  are  largely  re- 
presented among  thieves,  whose  occupation  demands 
the  possession  of  neither  courage,  energy,  nor 
brains. 

Of  those  begojbten  by  fathers  in  the  period  of 
maturity  we  note  that  sexual  offenders  are  the  only 
class  which  at  all  approach  the  normal  persons  in 
respect  of  mature  parentage.  We  also  notice  that 
amongst  murderers,  those  of  mature  parentage  are 
actually  fewer  than  among  the  insane  themselves. 

Of  those  of  senile  parentage  the  most  notable  fact 
is  the  remarkable  number  of  murderers  which  belong 
to  this  class.  Of  all  the  murderers  whose  ancestry 
was  inquired  into  by  Dr.  Marro,  52.9  per  cent, 
actually  turned  out  to  be  the  children  of  fathers  who 
had  passed  their  prime.  This  fact  corroborates  my 
estimate  of  this  degenerate  class,  and  fully  justifies 
the  assertion  that  low  cunning,  moral  perversion,  and 
heartless  cruelty  are  almost  constant  characters  in  the 
children  of  aged  parents.  This  class  is  also  liberally 
represented  among  sharpers  and  sexual  offenders, 
where  their  perverted  moral  feeling,  aided  on  the  one 
hand  by  their  cunning,  and  on  the  other  by  their  cruelty, 
would  lead  them ;  but  among  thieves,  where  the  off- 
spring of  the  immature  is  so  numerous,  they  are 
found  only  in  small  numbers,  their  percentage  being 
less  than  3  greater  than  among  normal  persons.  The 
cowardice  and  imbecility  of  the  children  of  the  imma- 
ture make  them  thieves  and  idiots ;  the  cunning  and 


264  MARRIAGE  AND  DISEASE. 

cruelty  of  tlie  children  of  the  aged  drive  them  beyond 
the  first  shallows  of  criminality. 

From  all  this  it  is  evident  that  marriages  among 
the  immature  and  the  aged  are  equally  opposed  to 
the  maintenance  of  physical,  mental,  and  moral  health 
among  the  people.  Such  unions  are  the  cause  of  an 
enormous  amount  of  child  suffering  and  death.  From 
the  offspring  of  these  unions  are  largely  recruited  the 
ranks  of  the  idiotic,  the  epileptic,  the  insane,  the 
scrofulous,  the  deaf-mute,  the  criminal,  and  every  class 
of  the  unfit,  which  are  a  drag  upon  the  state,  a 
fruitful  source  of  contamination  to  the  health  of  the 
populace,  and  a  reproach  to  our  civilisation. 

No  man  having  respect  for  his  own  health  or  that 
of  his  children  should  marry  until  he  has  at  least 
gained  his  majority,  and  the  nearer  he  approaches  the 
age  of  25  before  he  undertakes  the  responsibilities  of 
the  married  state,  so  much  the  better  for  both  him- 
self and  his  children. 

Men  who  are  past  their  prime  should  be  very  care- 
ful in  the  selection  of  wives,  and  should  remember 
that  the  health  and  vigour  of  a  mature  young  mother 
may  largely  neutralise  their  own  unfitness  as  fathers. 
From  this  last  remark  it  is  not  to  be  understood  that 
the  aged  man  should  marry  an  undeveloped  girl,  as  so 
many  do,  but  a  mature  woman  of  25  to  30  years  of 
age.  During  the  year  1889  no  less  than  75  men 
of  45  to  75  married  girls  of  20  to  15,  and  no  fewer 
than  193  women  of  35  to  50  married  men  of  2 1  or 
less.  (These  are  the  figures  as  given  by  the  parties 


LATE  MARRIAGES.  265 

themselves ;  and  in  estimating  their  value,  we  must 
not  forget  what  self-depreciation  in  this  particular  the 
blushing  bride  of  over  35,  or  the  budding  Benedict 
of  a  decade  later  is  capable  of.)  The  man  of  40  to 
50  should  marry  a  woman  of  25  to  30.  From  such 
a  union,  healthy  children  may  be  reasonably  looked 
for.  The  man  of  over  50*  unless  in  rare  instances 
where  the  strength  and  vigour  are  exceptionally  well 
maintained,  had  far  better  not  marry  with  a  view  to 
rearing  a  family.  Karely  indeed  will  he  live  in 
distant  posterity. 

To  advise  the  female  portion  of  humanity  as  to  the 
age  at  which  they  should  abandon  all  ideas  of  matri- 
mony, or  as  to  the  point  at  which  the  youthfulness  of 
a  husband  becomes  objectionable,  would,  I  fear,  be  a 
work  of  supererogation,  and  for  that  reason  I  shall 
not  enter  upon  it. 


13 


CHAPTER  XIX. 

CONSANGUINEOUS  MARRIAGES. 

THIS  is  a  subject  upon  which  it  is  necessary  to  say  a 
few  words  here,  as  it  is  a  matter  Sf  great  importance 
that  something  should  be  known  of  the  effect  of  the 
intermarriage  of  blood  relations,  more  especially  by 
members  of  families  in  which  exist  a  tendency  to  any 
hereditary  disease. 

It  is  popularly  believed  that  the  intermarriage  of 
persons  nearly  related  by  blood  leads  to  evil  conse- 
quences in  the  offspring,  and  in  proof  of  this  it  has 
been  pointed  out  that  such  imperfections  as  idiocy, 
insanity,  epilepsy,  deaf-mutism,  blindness,  scrofula, 
phthisis,  paralysis,  and  various  bodily  deformities,  are 
much  more  frequently  met  with  among  the  children 
of  parents  who  are  close  blood-relations  than  among 
those  of  parents  who  are  not  so  related.  Now,  that 
all  the  imperfections  above  mentioned  and  many 
others  are  met  with  among  the  children  of  consan- 
guineous marriages  is  true,  and  that  they  occur  here 
more  frequently  than  among  the  general  population  is 
also  true,  but  that  this  condition  of  affairs  is  due  to 


CONSANGUINEOUS  MARRIAGES.  267 

the  mere  fact  of  blood-relationship  in  the  parents  has 
been  disproved. 

It  cannot  be  said  that  consanguineous  unions  are 
repugnant  to  nature,  although  custom  and  religious 
teaching  have  developed  a  repugnance  thereto  in 
civilised  man.  From  the  early  history  of  mankind 
we  learn  that  marriages  between  very  close  blood 
relations  were  both  legal  and  common.  "  The  Persians, 
Tartars,  Scythians,  Medes,  Phoenicians,  Egyptians, 
and  Peruvians  not  only  married  their  sisters,  but 
their  daughters  and  their  mothers.  Instances  of  such 
marriages  among  the  members  of  the  royal  families 
of  antiquity  are  well  known."  Later,  the  laws  of  the 
ancient  Germans  permitted  consanguineous  marriages 
of  a  less  glaring  kind,  as  did  also  the  laws  of  the 
Arabs  until  the  time  of  Mahomet ;  and  the  Jews, 
notwithstanding  the  strict  injunctions  of  Moses,  con- 
tinue them  until  the  present  day,  as  do  also  that 
strange  people,  the  Gipsies. 

Nevertheless,  the  frequency  of  imperfection  in  the 
children  of  such  marriages  has  been  noticed  from 
the  time  of  Moses,  or  earlier,  as  is  proved  by  the 
fact  that  all  the  great  moral  codes — Hindu,  Mosaic, 
Eoman,  Christian,  and  Mussulman,  have  alike  for- 
bidden such  unions.  All  these  laws  were  evidently 
founded  on  the  belief,  which  is  still  generally  accepted 
by  those  who  have  not  studied  the  matter,  that  the  un- 
happy results  so  frequently  following  consanguineous 
marriages,  depended  upon  the  mere  fact  that  the 
parents  were  of  the  same  blood.  This,  however,  has 


268  MARRIAGE  AND  DISEASE. 

upon  inquiry  proved  to  be  erroneous;  yet  this  dis- 
covery has  in  no  way  lessened  the  practical  utility 
of  the  law  forbidding  the  marriage  of  blood  relations. 
In  fact,  there  is  much  more  need  of  a  strict  observ- 
ance of  this  law  nowadays  among  our  highly  civilised 
communities,  than  there  was  among  the  primitive 
peoples  to  whom  it  was  first  given. 

We  have  it  recorded  in  Holy  Writ  that  Abraham 
was  married  to  his  half-sister,  Isaac  to  his  first 
cousin  once  removed,  and  Jacob  to  his  first  cousin, 
and  that  the  stock  from  this  root  flourished  exceed- 
ingly. Huth,  in  his  "  Marriage  of  Near  Kin,"  cites 
several  instances  of  much  the  same  state  of  affairs 
occurring  regularly  at  the  present  day  among  certain 
isolated  communities,  such  as  the  inhabitants  of  St. 
Kilfo,  Pitcairn,  and  Iceland,  without  any  apparent 
evilWconsequences  to  the  race.  It  is  also  certain 
that  such  marriages  are,  or  were,  common  among  the 
North  American  Indians  and  the  South  Sea  Islanders, 
peoples  among  whom  idiocy  and  other  degenerate 
hereditary  conditions  were  remarkably  rare.  In  these 
cases,  however,  it  must  be  noticed  that  we  have 
peculiarly  healthy  communities  to  deal  with,  and 
therein  lies  the  secret  of  such  intermarriage  prov- 
ing innocent  of  evil  to  the  offspring.  Were  such 
marriages  common  among  the  neurotic,  decrepit, 
scrofulous,  and  otherwise  degenerate  dwellers  in  our 
great  cities  of  to-day,  the  result  would  be  disastrous. 

So  long  ago  as  1869  the  New  York  State  Medical 
Society  appointed  a  committee  of  its  members  to 


CONSANGUINEOUS  MARRIAGES.  269 

investigate  and  report  upon  the  influence  of  con- 
sanguineous marriages  upon  the  offspring,  and  the 
result  of  their  labours,  as  published  in  the  American 
Journal  of  Insanity,  1870,  shows  clearly  that  if  the 
family  be  free  from  degenerative  taint,  marriage  among 
its  members  in  no  way  diminishes  the  chances  of 
healthy  offspring.  This  conclusion  is  in  perfect  agree- 
ment with  the  findings  of  other  and  more  recent 
investigators,  such  as  Anstie,  George  Darwin,*  and 
A.  H.  Huth.  According  to  these  authorities,  there 
is  no  greater  amount  of  disease  or  deformity  among 
the  offspring  of  parents  related  to  each  other  by  blood, 
than  among  the  children  of  parents  not  so  related, 
provided  the  parents  be  equally  free  from  tendency 
to  disease  or  degeneration.  With  a  perfectly  healthy 
stock,  as  every  breeder  of  animals  knows,  "  in  and  in 
breeding  "  may  be  practised  with  impunity,  but  ^here 
the  stock  is  tainted  with  disease  or  imperfection, 
safety  is  only  to  be  found  in  "  crossing." 

Where  the  error  lay  in  the  old  doctrine,  upon 
which  was  founded  the  prohibition  of  consanguineous 
unions,  was  not  in  asserting  that  disease  and  deformity 
were  more  often  met  with  in  the  children  of  these 
than  in  those  of  other  unipns,  for  such  is  true,  but 
in  attributing  these  unhappy  results  to  the  mere  fact 
that  the  parents  were  related  by  blood.  Over  and 
above  the  fact  that  these  consanguineous  marriages 
are  almost  certain  to  transmit,  in  an  accentuated 
form,  any  defect  or  tendency  to  disease  already  present? 
*  Journal  of  Statistical  Society,  June  1875. 


270  MARRIAGE  AND  DISEASE. 

in  the  family,  there  is  no  physiological  reason  why  such 
marriages  should  not  take  place.  Breeders  of  prize 
stock  frequently  breed  "  in  and  in,"  not  only  with 
impunity,  but  with  marked  benefit.  But  this  fact, 
while  going  to  prove  that  it  is  not  the  mere  blood 
relationship  of  the  parents  which  induces  the  de- 
generate conditions  so  often  found  in  the  children  of 
consanguineous  marriages,  can  but  rarely  be  advanced 
as  an  argument  in  support  of  the  marriage  of  blood 
relations.  The  stock-raiser  only  permits  the  more 
perfect  members  of  his  flocks  and  herds  to  continue 
their  kind,  and  for  this  reason  the  "  in  and  in " 
breeding  is  innocuous,  just  as  it  would  be  in  the 
human  family  under  like  conditions.  But  where 
shall  we  find  the  perfect  human  family  ?  At  the 
present  time  such  families  are  certainly  rare.  The 
laws  of  natural  life  have  been  so  strained  and  per- 
verted by  our  civilisation,  that  almost  every  family 
nowadays  has  got  a  taint  or  twist  of  some  kind,  and 
as  all  such  imperfections  are  transmitted  and  rapidly 
deepened  and  fixed  in  the  family  by  the  intermarriage 
of  its  members,  it  is  best  that  such  unions  should  in 
all  cases  be  forbidden. 

As  we  have  already  seen,  recently  acquired  char- 
acters, whether  physiological  or  pathological,  are  very 
liable  to  disappear  when  the  individual  bearing  such 
character  intermarries  with  another  not  having  the 
same  character.  The  natural  tendency  in  all  such 
cases  is  to  revert  in  the  offspring  to  the  normal  or 
healthy  type,  so  that,  unless  the  new  character  be 


CONSANGUINEOUS  MARRIAGES.  271 

very  deeply  impressed  upon  the  parental  organism, 
it  is  almost  certain  it  will  not  appear  in  the  offspring, 
if  the  other  parent  have  nothing  of  the  character. 
But  when  both  parents  are  possessed  of  the  charac- 
ter, whether  it  be  physiological  or  pathological,  this 
natural  tendency  to  revert  to  the  original  is  often 
over-borne,  and  the  character  is  repeated  in  an 
accentuated  form  in  the  offspring. 

Now,  this  accentuation  of  all  family  characters 
is  what  must  always  happen  in  the  case  of  consan- 
guineous marriages.  If  there  be  any  taint  in  the 
family,  each  member  of  the  family  will  have  inherited 
more  or  less  of  it  from  the  common  ancestor.  Take 
the  case  of  cousins,  the  descendants  of  a  common 
grandparent  who  was  insane,  and  of  an  insane  stock. 
Here  the  cousins  are  certain  to  have  inherited  more 
or  less  of  the  insane  diathesis.  Even  if  the  taint 
has  been  largely  diluted  in  their  case  by  the  wise, 
or  more  likely  fortunate,  marriages  of  their  blood- 
related  parents,  yet  will  they  have  inherited  a  cer- 
tain tendency  to  nervous  disease,  and  if  they  marry, 
they  must  not  be  surprised  if  that  taint  appear  in 
an  aggravated  form  in  their  children.  Some  of 
the  children  of  such  parents  are  generally  idiotic, 
epileptic,  dumb,  or  scrofulous,  and  the  parents  marvel 
whence  came  the  imperfection.  It  may  be,  in  some 
cases,  that  the  parents,  and  possibly  the  grandparents, 
of  the  unfortunate  children,  have  not  up  till  that 
time  displayed  any  outward  evidence  of  the  tendency 
to  disease  which  they  have  inherited  and  handed 


272  MARRIAGE  AND  DISEASE. 

on  to  their  descendants,  and  not  looking  farther  back, 
the  parents  boldly  assert  that  such  a  thing  as  insanity, 
epilepsy,  scrofula,  &c.,  is  unknown  in  their  family. 
They  themselves  have  never  been  insane — why,  then, 
should  their  children?  In  like  manner  children  may 
be  epileptic,  blind,  mute,  scrofulous,  cancerous,  cri- 
minal, or  deformed  from  direct  inheritance,  and  yet 
the  family  line  be  honestly  declared  to  be  healthy. 
Hence  the  truth  of  Sir  William  Aitken's  words :  "  A 
family  history  including  less  than  three  generations 
is  useless,  and  may  even  be  misleading." 

In  consanguineous  marriages,  then,  the  danger 
lies  in  the  strong  probability  there  is  of  both  parents 
bearing  some  particular  taint  of  degeneration,  which 
will  be  deepened  in  their  children,  yet  which  might 
be  escaped  if  they  each  married  a  person  not  bearing 
that  same,  or  some  allied,  character.  The  blood 
relationship  in  itself  is  innocent.  It  is  the  double 
tendency  to  disease  which  brings  about  the  evil  to 
the  children.  The  marriage  of  two  phthisical,  or 
scrofulous,  or  neurotic  persons,  whose  families  know 
nothing  of  each  other,  would  be  equally  pregnant 
of  evil  with  the  marriage  of  cousins,  or  even  nearer 
blood  relations  similarly  tainted. 

From  the  foregoing  it  is  evident  that  the  similarity 
of  temperament  induced  by  a  common  environment, 
and  which  I  would  call  "  social  consanguinity/'  must 
be  a  potent  factor  in  the  production  of  all  hereditary 
degenerations.  Living  under  similar  customs,  habits, 
and  surroundings,  labouring  at  the  same  occupation, 


CONSANGUINEOUS  MARRIAGES.  273 

indulging  in  the  same  dissipations,  tends  to  engender 
like  diseases  and  degenerations  irrespective  of  any 
blood  relationship.  Hence  it  not  seldom  happens 
that  persons  not  even  distantly  related  by  blood, 
are,  in  reality,  much  more  nearly  related  in  tempera- 
ment than  cousins,  or  even  nearer  blood  relations, 
who  have  experienced  widely  different  modes  of 
life.  This  "  social  consanguinity  "  is  the  great  curee 
which  dogs  every  exclusive  tribe  and  class,  and  hurries 
them  to  extinction.  It  has  largely  aided  real  or 
family  consanguinity  in  the  production  of  the  disease 
and  degeneration  which  have  so  heavily  fallen  upon 
the  aristocracies  and  royal  families  of  Europe.  There- 
fore the  introduction  of  plebeian  blood  into  the  noble 
family  is  to  be  applauded,  not  only  as  being  poetic,  but 
as  being  useful.  The  "  lady  of  low  degree  "  frequently 
brings  with  her  a  heritage  of  health  more  valuable 
than  silver  or  gold.  But  when  she  brings  gold  too, 
as  does  the  modern  American  representative  of  the 
"  Gipsy  Countess  "  of  old,  there  appears  nothing  left 
to  be  desired. 

The  important  part  played  by  this  "  social  consan- 
guinity" in  bringing  about  family  degeneration,  is 
well  illustrated  both  positively  and  negatively  in  the 
case  of  the  Jews.  This  race  has  permitted  the  inter- 
marriage of  near  blood  relations  from  the  earliest 
times  up  to  the  present,  and  such  unions  have  at 
all  times  been  common  amongst  them.  Yet  the 
Jews  have  for  centuries  maintained  a  physical  and 
intellectual  standard  quite  up  to  the  average  of 


274  MARRIAGE  AND  DISEASE. 

modern  peoples,  and  that,  too,  notwithstanding 
frequent  and  cruel  oppression.  To  my  mind  this 
strange  immunity  from  degeneration,  after  centuries 
of  consanguineous  unions,  is  only  to  be  accounted  for 
by  the  absence  of  "  social  consanguinity "  among 
this  people.  The  Jew  has  been  for  centuries  a 
wanderer  upon  the  face  of  the  earth ;  a  veritable 
rolling-stone,  though  differing  from  the  proverbial 
rolling-stone  in  its  one  grand  characteristic.  He  is 
without  a  country,  therefore  without  patriotism,  and 
consequently  never  a  soldier ;  but,  except  on_ih© 
battlefield,  there  is  no  spot  on  the  earth's  surface 
where  wealth  and  honour  are  to  be  won  that  the  Jew 
is  not  to  be  found — not  as  a  settler,  merely  as  a 
temporary  sojourner.  He  has  few  ties,  and  he  has 
no  love  for  one  country  more  than  another.  So  he 
moves  from  town  to  town  from  country  to  country, 
from  continent  to  continent  in  pursuit  of  wealth, 
his  wandering  bringing  about  such  change  of  en- 
vironment that  anything  approaching  the  "  social 
consanguinity  "  constantly  met  with  among  European 
aristocracies  is  impossible. 

The  same  might,  to  a  certain  extent,  be  said  of  that 
other  race  of  wanderers  upon  whom  repeated  con- 
sanguineous marriages  seem  to  bring  no  blight — 
the  Gipsies.  In  the  case  of  the  Gipsies,  however, 
much  of  their  immunity  from  degenerative  disease 
doubtless  depends  upon  their  more  natural  mode  of 
life,  and  consequent  large  store  of  physical  health, 
as  is  undoubtedly  the  case  among  savage  tribes 


CONSANGUINEOUS  MARRIAGES.  275 

and  such  communities  as  those  of  Pitcairn  and  St. 
Kilda. 

It  is  certain,  then,  that  consanguineous  marriages 
must  be  extremely  dangerous  in  communities  like 
our  own.  Where  the  laws  of  natural  life  are  so  gravely 
interfered  with  they  should  rarely,  indeed,  be  entered 
into,  if  at  all.  Yet  we  must  admit  that  just  as  we 
can  cultivate  by  "  in -and -in -breeding"  pathological 
or  degenerate  characters  such  as  the  insane,  gouty, 
or  scrofulous  diathesis,  so  it  is  possible,  by  the  same 
means,  to  foster  physiological  or  healthy  characters. 
The  natural  law  works  for  good  as  well  as  for  evil, 
and  it  is  possible,  by  means  of  intermarriage  of  those 
belonging  to  a  family  noted  for  some  physical  or 
intellectual  excellence,  to  deepen  and  fix  that  good 
character  in  the  family.  Thus,  the  marriage  of 
cousins  in  whom  the  literary,  artistic,  musical,  or 
other  talent  is  prominent  will  in  all  probability  pro- 
duce children  in  whom  the  particular  talent  of  the 
parents  will  be  still  more  strongly  marked.  A  good 
example  of  this  is  found  in  the  numerous  family  of 
the  Bachs,  the  musicians,  who  freely  intermarried, 
and  elevated  their  talent,  possessed  by  all,  to'  the 
level  of  genius  in  some  of  their  members. 

In  this  manner  any  mental  or  physical  character 
may  be  transmitted,  deepened  with  each  transmission, 
and  finally  fixed  as  a  constant  character  in  the  family. 
Even  what  might  be  called  accidental  characters, 
or  peculiarities,  may  be  seized  upon  by  the  breeder 
and  fixed  in  the  family.  This  is  constantly  done  by 


276  MARRIAGE  AND  DISEASE. 

breeders  of  our  domestic  animals.  Of  supernumerary 
fingers  and  toes — a  common  deformity  in  the  human 
species  since  the  days  of  David,  when  "  Jonathan, 
the  son  of  Shimeah,  the  brother  of  David,"  killed  in 
battle  the  Philistine  of  great  stature,  who  "  had  on 
every  hand  six  fingers,  and  on  every  foot  six  toes, 
four-and-twenty  in  number ;  " — of  this  deformity  Sir 
William  Lawrence  says  : — "  If  the  six-fingered  and  six- 
toed  could  be  matched  together,  and  the  breed  could 
be  preserved  pure  by  excluding  all  who  had  not  these 
additional  members,  there  is  no  doubt  that  a  perma- 
nent race  might  be  formed,  constantly  possessing  this 
number  of  fingers  and  toes."  * 

This  assertion  of  Sir  William  might  be  imagined 
by  some  to  be  extravagant,  whereas  it  is,  in  reality, 
well  within  the  bounds  of  probability.  The  fact 
that  accidental  peculiarities  can  be  reproduced  and 
fixed  as  constant  characters  is  well  known,  and  con- 
stantly taken  advantage  of  by  breeders.  The  best 
instance  of  this  which  I  can  cite  is  that  of  the  An  con 
sheep.  The  peculiarities  of  this  variety  of  the  sheep 
family,  which  is  now  largely  bred  in  America,  first 
appeared  in  a  somewhat  deformed  lamb,  born  of 
ordinary  parents.  "  The  first  ancestor  of  this  breed 
was  a  male  lamb,  produced  by  a  ewe  of  the  common 
description.  This  lamb  was  of  singular  structure, 
and  his  offspring,  in  many  instances,  had  the  same 
characters  with  himself :  these  were,  shortness  of  the 

*  "Lectures  on  Physiology,  Zoology,  and  Natural  History  of 
Man." 


CONSANGUINEOUS  MARRIAGES.  277 

limbs,  and  greater  length  of  the  body  in  proportion : 
whence  this  race  of  animals  has  been  termed  the 
otter-breed  (otherwise  the  Ancon  sheep).  The  joints 
also  were  longer,  and  the  forelegs  crooked.  It  has 
been  found  advantageous  to  propagate  this  variety 
because  the  animal  is  unable  to  jump  over  fences."  * 

But  although  consanguineous  marriages  might  thus 
be  used  to  develop  desirable  characters  in  families, 
such  breeding  of  genius  is  not  to  be  advocated,  for 
this  reason :  Few  families  are  physiologically  perfect, 
most  have  got  some  unhealthy  taint,  and  while  the 
desired  character»was  being  deepened  and  fixed  by  suc- 
cessive consanguineous  unions,  we  would  in  most  cases 
be  building  up  at  the  same  time  some  pathological 
character.  This  latter  would  increase  as  surely  as 
the  former,  and  on  reaching  the  necessarily  fatal 
degree  would  put  an  end  to  the  family  altogether. 
For  this  reason,  if  there  were  no  other,  real  or  family 
consanguinity  should  be  avoided  in  marriage,  as 
should  also  that  which  I  have  called  "social  con- 
sanguinity." 

From  time  immemorial  it  has  been  known  that 
"  the  introduction  of  new  blood  "  has  a  beneficial  effect 
upon  the  family  or  race,  and  proof  of  the  truth  of  this 
old-time  doctrine  is  to  be  had  on  every  hand,  both  in 
the  human  family  and  among  the  brute  creation.  The 
most  beautiful  families  of  the  south  are  said  to  be 
those  which  proceed  from  the  alliance  of  Germans  or 

*  "  Kesearches  into  the  Physical  History  of  Mankind,"  by  J.  C. 
Prichard,  F.K.S. 


278  MARRIAGE  AND  DISEASE. 

Hollanders  with,  the  women  of  the  country,*  while  the 
families  of  Berlin  most  remarkable  for  their  beauty, 
their  force,  and  their  intelligence  proceed  from  French 
exiles  who  married  ladies  of  Berlin.!  Nearer  home,  in 
Ireland  we  have  positive  evidence  of  the  beneficial 
effect  of  "  crossing  "  with  fresh  blood.  In  the  counties 
of  Tipperary  and  Limerick,  where  great  numbers  of 
Cromwell's  English  soldiers  settled,  the  people  are 
noted  for  their  splendid  physical  development  and 
wild  daring  spirit.  Again,  in  Ulster,  where  the  Low- 
land Scots  planted  there  by  James  have  blended  with 
the  earlier  Celt,  the  present  inhabitants  are  physically 
superior  to  those  of  any  other  part  of  the  kingdom, 
while  in  mental  acuteness  and  energy  they  are  second 
to  none.  The  superiority  of  these  mixed  races  is  at 
once  evident  to  the  traveller  in  Ireland.  On  this 
point  Dr.  Prichard  remarks  : — "In  some  parts  of  Ireland 
where  the  Celtic  population  of  that  island  is  nearly 
unmixed,  they  are,  in  general,  a  people  of  short 
stature,  small  limbs  and  features ;  where  they  are 
mixed  with  English  settlers,  or  with  Lowlanders  of 
Scotland,  the  people  are  remarkable  for  fine  figures, 
tall  stature,  and  great  physical  energy."  J 

And  now  as  to  the  lessons  to  be  drawn  from  all 
this.  We  learn,  in  the  first  place,  that  consanguineous 
unions  are  in  all  cases  dangerous,  and  are  becoming, 
with  our  advancing  civilisation,  more  dangerous  every 
year.  They  are  therefore  to  be  discountenanced  even 

*  Lallemand. 
t  Devay's  "  Du  Danger  des  Mariages  Consanguins."      $  Op.  cit. 


CONSANGUINEOUS  MARRIAGES.  279 

in  healthy  families,  for  such  unions  may  wake  up 
some  pathological  character  which  has  been  latent  for 
one  or  two  generations. 

In  the  next  place,  consanguineous  marriages  should 
not  be  thought  of  in  any  family  in  which  idiocy, 
insanity,  suicide,  epilepsy,  scrofula,  phthisis,  gout, 
cancer,  deaf-mutism,  club-foot,  cleft-palate,  hare-lip, 
rheumatism,  heart-disease,  chorea,  neuralgia,  or  crime 
is  known  to  be  hereditarily  transmitted,  or  where  they 
have  appeared  in  one  or  more  generation,  no  matter 
how  far  back. 

And  finally,  we  must  remember  the  effect  of  "  social 
consanguinity,"  and  not  be  too  exclusive  in  marriage. 
Let  royalty  renew  and  oxidise  its  blue  blood  to  arterial 
crimson  at  the  fountain  of  health,  even  if  it  have  to 
stoop  to  the  life-giving  stream.  Let  the  noble  im- 
prove his  condition  physically,  mentally  (and  finan- 
cially) by  espousing  the  pleb  of  the  occidental  Republic. 
And  if  the  diseased  will  marry,  let  him  be  unselfish 
enough  to  consider  those  to  follow  him :  let  him 
mitigate  his  innate  unfitness  so  far  as  in  him  lies. 
Let  the  neurotic  take  unto  him  the  level-headed,  and 
the  feeble  the  robust,  and  brave  the  anger  of  the  blind 
god  Cupid. 


CHAPTER  XX. 

INSTINCTIVE  CRIMINALITY. 

No  work,  however  unpretentious,  purporting  to  treat 
of  family  degenerations,  could,  at  the  present  day,  be 
considered  complete,  which  did  not  give  a  place  to  the 
class  of  instinctive  criminals. 

The  study  of  this  abnormal  variety  of  the  human 
animal,  although  still  in  its  infancy,  is  one  of  the 
oldest  of  the  natural  sciences.  Indeed,  it  is  as  old — 
if  not  even  older,  than  man  himself.  Clearly  the 
study  of  the  criminal  had  its  origin  in  the  pseudo- 
science'  known  to-day  as  Physiognomy,  and  this  we 
can  trace  down  through  all  races  to  primitive  man,  and 
not  a  little  way  further  down  still  among  the  inferior 
animals. 

The  face  of  man,  being  much  more  expressive  than 
that  of  any  of  the  animals  beneath  him  in  the  scale  of 
development,  gives  a  much  clearer  and  truer  reflec- 
tion of  the  passions  and  desires  passing  in  the  brain 
behind  it.  Every  thought  passing  through  the  human 
mind,  cruel  or  kind,  beautiful  or  brutal,  is  reflected 
more  or  less  clearly  upon  the  features.  If  a  thought, 
passion,  or  desire  be  but  transient,  the  moulding  effect 


INSTINCTIVE  CRIMINALITY.  281 

upon  the  features  may  also  be  transient,  but  if  it 
be  long  continued,  or  if  it  frequently  recur,  be  it 
good  or  evil,  assuredly  it  will  leave  an  indelible 
imprint  upon  the  countenance  that  may  be  read  of  all 
men. 

This  was  the  teaching  of  the  school  of  which  the 
famous  Lavater  is  the  best  known  exponent,  and 
in  it  we  have  to  a  certainty  the  origin  of  Criminal 
Anthropology. 

For  physiognomy  there  is  much  to  be  said.  In 
the  concrete  it  is  largely  if  not  absolutely  true.  But, 
lacking  as  it  does  a  scientific  basis,  it  can  never  be 
depended  upon  as  a  guide  in  individual  cases.  Never- 
theless it  is  practised  daily  by  every  grade  of  humanity, 
from  the  naked  savage  to  the  ermine-clad  occupant  of 
the  seat  of  justice,  as  it  is  also  by  many  of  the  infe- 
rior animals.  It  is  by  the  exercise  of  this  instinctive 
power  of  face-reading  that  the  dog  knows  when  his 
ferocious  fellow  may  be  approached  in  a  playful 
humour,  and  when  it  is  wise  to  keep  a  respectful 
distance,  or  that  he  discovers  the  mood  of  his  human 
master  at  a  single  look.  It  is  by  the  exercise  of  this 
very  same  instinct  that  judges  and  juries  are  pre- 
judiced for  and  against  persons  appearing  before  them 
in  court,  and  that  we  ourselves  discover  the  man 
whom  we  "  wouldn't  trust  farther  than  we  could  throw 
him,"  without  a  shred  of  evidence  against  him  save 
what  we  can  see  of  the  inner  man  shining  through 
his  tell-tale  countenance. 

Before  man  arrived  at  that  stage  of  development 

19 


282  MARRIAGE  AND  DISEASE. 

wherein  he  devised  laws  for  the  protection  of  the 
feeble  and  good  against  the  machinations  of  the  strong 
and  evil,  the  exercise  of  this  instinct  was  as  necessary 
for  self-preservation  in  the  human  family  as  it  had 
been  in  the  case  of  the  lower  animals,  from  which  he 
inherited  the  gift.  Its  presence  to-day  in  our  children 
is  a  sad  commentary  on  the  success  of  our  civilisation. 
Had  the  laws  devised  by  man  given  anything  like 
perfect  protection  to  the  just  against  the  unjust,  or 
civilisation  eliminated  the  evil  instincts  natural  to 
uncivilised  man,  this  character  must,  like  many  another 
primitive  character,  have  grown  dim,  faded,  and  finally 
disappeared  as  useless  in  the  economy.  But  as  no 
civilisation  can  ever  make  the  bad  good,  and  no  law 
can  ever  fully  protect  the  weak  and  honest  against 
the  strong  and  dishonest — at  least  no  law  yet  devised 
— we  find  this  character,  which  made  its  appearance 
very  early  in  the  process  of  evolution,  handed  on  from 
parent  to  child  in  the  highest  ranks  of  civilised 
humanity,  as  it  was  among  our  poor  relations  ages 
before  we  came  into  existence. 

The  next  step  in  the  evolution  of  Criminal  Anthro- 
pology, which  dates  from  the  time  of  Aristotle  or 
earlier,  was  attained  with  the  establishment  of  Phren- 
ology, that  is,  when  man  began  to  note  how  certain 
instincts  and  passions  in  his  fellows  were  associated 
with  certain  peculiarities  of  cranial  development.  Here 
the  natural  philosopher  was  on  surer  ground  ;  but,  as 
in  physiognomy,  and  for  the  same  reason,  viz.,  want 
of  any  scientific  basis,  his  conclusions  in  individual 


INSTINCTIVE  CRIMINALITY.  283 

cases  could  never  be  looked  upon  as  accurate,  how- 
ever true  they  might  be  when  he  generalised. 

The  man  with  well-shaped  skull,  lofty  forehead, 
and  benevolent  expression,  may  be  and  occasionally 
is  a  moral  imbecile,  an  instinctive  criminal,  and  the 
man  with  small  brain-pan,  low,  retreating  forehead, 
bull-neck,  heavy  jaw,  and  brutal  expression  may  be 
and  perhaps  occasionally  is  a  philanthropist ;  there- 
fore the  phrenologist  must  fail,  with  the  physiognomist, 
notwithstanding  the  fact  that  if  we  take  a  hundred 
men  of  the  first  type  there  may  not  be  an  instinctive 
criminal  amongst  them,  and  if  we  take  a  hundred  of 
the  second  type  we  may  find  but  few  who  are  not 
immoral,  brutal,  or  criminal  by  nature. 

Since  the  days  of  Aristotle,  many  observers  have 
commented  on  the  differences  commonly  appearing 
between  the  criminal  and  the  average  law-abiding 
citizen.  For  ages  it  was  noticed  that  criminals,  as 
a  class,  had  characters  more  or  less  peculiar  to  them- 
selves. Later  it  was  remarked  that  these  characters 
were  in  reality  signs  of  degeneration,  and  that  they 
were,  like  all  other  family  characters,  hereditarily  trans- 
mitted. The  soundness  of  these  early  observations 
has  been  proved  by  recent  scientific  investigation,  and 
it  is  now  recognised  on  all  hands  that  the  instinctive 
criminal  is  an  abnormal  and  degenerate  type  of 
humanity. 

Unfortunately,  although  the  study  of  the  criminal 
was  begun  so  long  ago,  it  is  only  in  recent  years 
that  any  attempt  has  been  made  to  study  scientifically 


284  MARRIAGE  AND  DISEASE. 

the  physical,  moral,  and  intellectual  development  of 
this  abnormal  human  type.  In  this  study  the  Italians, 
with  Professor  Cesare  Lombroso  at  their  head,  lead 
the  van,  as  the  representatives  of  the  most  criminal  of 
all  civilised  countries  properly  should.  Already  the 
work  has  been  taken  up  with  vigour  in  almost  every 
continental  European  state,  and  in  America.  Time 
was  when  in  Bruce  Thomson,  Maudsley,  Wilson,  and 
Nicolson,  England  could  boast  of  some  workers  in 
this  field,  but  unfortunately  at  present  little  is  being 
done  at  home  to  advance  our  knowledge  of  that 
troublesome,  expensive,  and  interesting  item  of  society, 
the  criminal.  It  is  to  be  hoped,  however,  that  the 
recently  published  excellent  work  of  Mr.  Havelock 
Ellis,*  which  has  attracted  so  much  attention,  will,  by 
making  known  what  is  being  done  in  this  branch  of 
natural  science  in  other  countries,  awaken  Englishmen 
to  a  sense  of  the  great  importance  of  the  subject,  and 
stimulate  prison  officials,  psychologists,  and  others  to 
careful  research  among  the  inmates  of  our  prisons. 

We  know  that  when  degeneration  attacks  the 
system  its  ravages  are  never  confined  to  any  one  tissue 
or  organ,  and  to  this  rule  the  instinctive  criminal  is 
no  exception.  His  moral  sense  t  is  in  process  of 

*  "  The  Criminal."    1891. 

t  "  Moral  feeling ...  is  a  function  of  organisation,  and  is  as 
essentially  dependent  upon  the  integrity  of  that  part  of  the  nervous 
system  which  ministers  to  its  manifestations  as  any  other  display 
of  mental  function.  .  .  .  When  it  is  not  exercised  it  decays,  and 
so  leads  to  individual  degeneration,  and,  through  individuals,  to 
degeneracy  of  race." — Maudsley  in  "  Kesponsibility  in  Mental 
Disease,"  p.  60. 


INSTINCTIVE  CRIMINALITY.  285 

decay,  but  that  is  not  his  only  blight.  Primarily  it  is 
his  moral  sense  which  is  at  fault,  and  leads  him  to 
offend  against  society,  but  it  is  seldom  indeed  that  we 
find  any  of  his  class  at  all  approaching  perfection, 
either  intellectually  or  physically.  He  is  a  moral 
imbecile.  He  lacks  the  moral  sense  as  the  idiot  lacks 
the  intellectual,  and  in  both  cases  the  whole  economy 
is  more  or  less  degenerate  and  imperfect.  As  we  find 
the  intellectual  want  in  the  idiot  associated  with 
physical  deformity  and  moral  perversion,  and  in  the 
physically  degenerate  we  discover  mental  weakness  or 
disorder  and  a  generally  depraved  condition  of  the 
whole  man,  so  in  the  criminal  we  find  the  moral  decay 
accompanied  in  the  majority  of  cases  by  physical 
degenerations  and  deformities,  together  with  intel- 
lectual weakness,  epilepsy,  and  all  kinds  of  neurotic 
conditions. 

As  Maudsley  says,  "  The  criminal  class  constitutes 
a  degenerate  or  morbid  variety  of  mankind,  marked 
by  peculiarly  low  physical  and  mental  characteristics. 
.  .  .  They  are  scrofulous,  not  seldom  deformed,  with 
badly-formed  angular  heads  ;  are  stupid,  sullen,  sluggish, 
deficient  in  vital  energy,  and  sometimes  afflicted  with 
epilepsy."  Dr.  G.  Wilson  stated  in  1869  that  "40 
per  cent,  of  all  convicts  are  invalids,  more  or  less ;  and 
that  percentage  is  largely  increased  by  the  professional 
thief  class."  *  This  is  10  to  20  per  cent,  under  the 
estimate  of  the  medical  officers  of  prisons  at  the 
present  day,  who  find  less  than  50  per  cent,  of  all 

*  British  Medical  Journal,  1869. 


286  MARRIAGE  AND  DISEASE. 

prisoners  fitted  for  hard  labour.  Dr.  Clouston,  in  hig 
Morison  Lectures  delivered  at  the  Koyal  College  of 
Physicians,  Edinburgh,  in  November  1890,  said  that 
he  had  "  examined  the  prisoners  in  the  Edinburgh 
prison,  many  of  whom  were  habitual  criminals.  A 
large  proportion  of  these  were  of  the  degenerate  class, 
mentally  and  bodily,  and  fully  one  half  were  in  face, 
stature,  and  appearance  far  below  any  minimum 
standard  of  healthy  human  development."  * 

All  who  have  examined  the  inmates  of  our  prisons 
agree  that  they  are  a  degenerate  and  a  decaying  race. 
They  are  scrofulous,  and  great  numbers  of  them  die 
from  various  forms  of  tubercular  disease.  During 
eight  years  50  per  cent,  of  the  deaths  occurring  at 
the  Elmira  Reformatory,  New  York,  are  stated  by 
Dr.  Wey  to  have  been  due  to  "  diseases  of  the  chest 
other  than  heart  disease."  Nervous  affections  also 
carry  off  considerable  numbers.  Again,  tissue  de- 
generations such  as  are  found  in  the  gouty  and 
rheumatic  are  commonly  met  with  even  among  the 
comparatively  young,  as  proved  by  the  fact  that  Penta 
found  44  per  cent,  suffering  from  earthy  degeneration 
of  the  tissues,  and  Flesch  50  per  cent,  with  heart 
disease,  of  which  20  per  cent,  actually  died. 

According  to  the  report  of  the  Medical  Inspector  of 
English  Prisons  the  death-rate  among  our  convict 
population  is  close  upon  a  half  higher  than  among 
the  general  population  at  corresponding  ages,  notwith- 
standing that  the  health  of  prisoners  is  looked  after 
*  Lancet,  November  29,  1890 


INSTINCTIVE  CRIMINALITY.  287 

more  sedulously  than  that  of  almost  any  other  class, 
rich  or  poor. 

The  criminal  is  more  nearly  allied  to  the  insane, 
especially  the  congenital  insane,  than  to  any  other 
class,  and  personally  he  bears  a  strong  family  likeness 
to  his  near  relative  the  idiot.  In  the  criminal  we  find 
small,  over-large,  and  ill-shapen  heads ;  paralysis, 
squints,  asymmetrical  faces,  deformed,  shrunken,  ill- 
developed  bodies ;  abnormal  conditions  of  the  genital 
organs,  large  heavy  jaws,  outstanding  ears,  and  a 
restless,  animal-like,  or  brutal  expression,  all  of  which 
are  common  characters  among  the  inmates  of  our  idiot 
and  imbecile  asylums.  And  as  there  is  no  beauty  to 
be  found  among  the  inmates  of  our  asylums,  neither 
is  there  any  to  be  discovered  in  our  prisons,  which 
shows  how  well  founded  is  that  instinctive  feeling  of 
repulsion  excited  by  the  sight  of  the  ill-favoured  and 
deformed. 

Of  a  truth  the  insane,  the  idiotic,  the  epileptic,  and 
the  criminal  are  bone  of  one  bone  and  flesh  of  one 
flesh.  They  spring  from  like  parents  and  succumb 
to  like  diseases.  Until  recently  their  relationship 
was  recognised.  The  same  devil  in  whose  service 
the  criminal  delights  "  possessed "  the  maniac,  tore 
the  epileptic,  and  robbed  the  idiot  of  his  God-sent 
reason,  and  the  overt  act  of  the  criminal,  the  epileptic, 
and  the  insane  alike  was  awarded  the  dungeon  cell 
and  the  whip.  Happily  the  day  of  corporal  punish- 
ment for  the  maniac  is  past:  recognising  his  inability 
to  change  his  nature,  we  now  humanely  seclude  him 


288  MARRIAGE  AND  DISEASE. 

from  the  society  with  which  his  faulty  conformation 
of  mind  unfits  him  to  mix.  How  long  it  may  be 
before  we  come  to  treat  the  instinctive  criminal  in 
like  rational  manner,  it  is  impossible  to  say,  but  that 
the  day  is  fast  approaching  there  is  ample  evidence. 

The  hereditary  character  of  this  peculiar  degenera- 
tion, instinctive  criminality,  has  been  recognised  from 
very  early  times  in  the  world's  history.  It  was  advo- 
cated and  demonstrated  by  Aristotle  and  his  follower 
Galen,  and  it  had  been  recognised  by  the  Jews  cen- 
turies before. 

As  regards  mode  of  transmission,  criminality  follows 
the  same  lines  as  most  other  family  degenerations. 
In  some  cases  it  is  transmitted,  like  the  suicidal 
impulse,  unchanged  through  several  generations,  as 
was  the  case  in  the  family  whose  genealogical  tree  I 
here  reproduce  from  Eossi  (Studio  sopra  una  Centuria 
di  Criminali). 

E.  S. 

Insane. 

-il F, 


M.- 

Thief.         Convicted 

of 
wounding. 


-M. M. 

Convicted  of        Thief.         Thief. 

wounding 

and  fraud. 
A  drunkard. 


it  M.  £  M.               M.                &                 A 

Thief.  Pickpocket.  Convicted  Thief.      Receiver.      Thief.        Honest 

Convicted  Five  times  of  and 

of  feigned  fraud.  healthy, 

wounding.  madness. 


In  this  wretched  family  the  insanity  of  the  maternal 
grandfather  produced  instinctive  criminality  in  each  of 


INSTINCTIVE  CRIMINALITY.  289 

his  three  children.  Where  the  criminal  taint  on  the 
paternal  side  came  from  we  do  not  know,  but  that 
it  was  strong  and  of  some  standing  in  the  family 
is  evidenced  by  the  fact  that  every  single  one  of 
the  six  sons  of  this  unhappy  couple  proved  to  be 
instinctive  criminals.  Such  cases  are,  however,  ex- 
ceptional. 

Sometimes,  in  a  decaying  family,  in  which  instinc- 
tive criminality  has  hitherto  been  unknown,  a  genera- 
tion of  criminals  will  appear,  just  as  a  generation  of 
deaf-mutes  or  epileptics  occasionally  appears,  in  families 
of  the  'insane  or  scrofulous  diathesis.  But  this,  again, 
is  rare.  In  the  majority  of  cases,  criminality  appears 
in  only  one,  two,  or  three  members  of  a  family,  the 
brothers  and  sisters  showing  the  taint  in  various  ways. 
One  will  be  scrofulous,  or  a  deaf-mute,  another  insane, 
idiotic,  epileptic,  a  suicide,  a  prostitute,  &c.,  as  the 
case  may  be.  Here  is  the  genealogical  tree  of  such  a 
family :  * 


Father.— 
Drunken. 


Mother. 

Insane. 


.   .1  I  '! 

M.  M.  M.  F.  F. 

Suicide.  Criminal.  Criminal.  Insane.  Imbecile. 


Here  we  have  the  combined  drunkenness  and  in- 
sanity of  the  parents  appearing  in  their  unfortunate 
offspring  as  suicide,  criminality,  insanity,  and  idiocy. 
In  the  following  family  we  have  the  order  of  things 
reversed.  In  it  the  criminality  of  the  parent  becomes 

*  Journal  of  Mental  Science,  Oct.  1872.     H.  Maudsley,  M.D. 


290  MARRIAGE  AND  DISEASE. 

suicide,  criminality,  and  epileptic  imbecility  in  his 
children,  and  insanity  in  his  grandchild.  This  genea- 
logical tree  is  from  the  same  source  as  the  preceding : — 


] 

Suit 

Acute  intelligence, 
wi'h  murder  and 
robbery. 

I                                   | 
f.                                 M.                                 M                         Epileptic 
ide.                       Criminal                       Suicide, 
(homicidal). 

F. 

Insane. 


I  should  here  remark  that  the  prostitute  ranks  with 
the  petty  criminal  offender  of  the  male  sex.  She 
bears  all  the  well-marked  signs  of  degeneration  found 
in  male  thieves,  swindlers,  and  vagabonds,  and  accounts 
to  a  certain  extent  for  the  large  excess  of  male  over 
female  criminals.  It  is  common  to  find  in  degenerate 
families  where  the  sons  take  to  crime  the  daughters 
take  to  prostitution.  In  the  famous  "  Jukes  family  " 
of  criminals,  for  example,  the  percentage  of  prostitu- 
tion among  the  marriageable  women  down  to  the 
sixth  generation  was  52.40:  the  percentage  of  pros- 
titution in  the  population  generally  has  been  esti- 
mated at  1.66. 

The  proportion  of  male  to  female  criminals  varies 
considerably  in  different  countries,  but  in  all  the 
women  are  decidedly  less  criminal  than  the  men. 
Unfortunately  in  England  there  has  been  a  marked 
and  steady  increase  in  the  proportion  of  female 
criminals  within  recent  years.  How  far  this  may  be 


INSTINCTIVE  CRIMINALITY.  291 

due  to  woman's  adoption  of  the  ways,  manners,  educa- 
tion, and  mode  of  life  of  man  is  too  large  a  question 
to  broach  here,  but  there  can  be  little  doubt  that  for 
the  reason  she  is  acquiring  gout,  general  paralysis, 
and  other  diseased  conditions  once  almost  or  wholly 
confined  to  man,  modern  woman  is  also  acquiring 
criminality.  If  woman  will  invade  what  has  hitherto 
been  looked  upon  as  man's  sphere  of  labour,  she  must 
riot,  in  the  struggle  for  the  prize,  expect  to  escape  the 
heat  and  burden  of  the  day  and  its  consequences. 

We  have  already  seen  (p.  262)  that  criminals, 
even  when  we  include  all  classes,  stand  midway 
between  normal  persons  and  the  insane  as  regards 
mature  parentage ;  and  if  we  inquire  farther  we  dis- 
cover that  age  is  not  the  only  point  upon  which  the 
parents  of  criminals  resemble  those  of  insane,  epileptic, 
idiotic,  scrofulous,  and  otherwise  degenerate  persons. 
Drunkenness,  for  instance,  the  most  active  agent  of 
degeneration  known,  which  we  recognise  as  a  potent 
cause  of  idiocy,  epilepsy,  insanity,  scrofula,  suicide,  and 
every  other  form  of  constitutional  degeneration,  has 
been  known  since  the  days  of  Galen  to  be  one  of  the 
most  fruitful  sources  of  instinctive  criminality.  "  Care- 
fully drawn  statistics  of  the  4000  criminals  who  have 
passed  through  Elmira  Reformatory,  New  York,  show 
drunkenness  clearly  existing  in  the  parents  in  38.7 
per  cent.,  and  probably  in  1 1. 1  per  cent.  more.  Out 
of  7 1  criminals  whose  ancestry  Rossi  was  able  to  trace, 
in  20  the  father  was  a  drunkard,  in  1 1  the  mother. 
Marro  found  that  on  an  average  4 1  per  cent,  of  the 


292  MARRIAGE  AND  DISEASE. 

criminals    he    examined    had    a    drunken   parent,   as 
against  1 6  per  cent,  of  normal  persons."  * 

Dr.  Ernile  Laurent,  in  his  recent  valuable  work  t 
on  the  inmates  of  the  prisons  of  Paris,  asserts  that 
drunkenness,  alone  or  combined  with  some  other 
neurotic  condition,  is  to  be  found  in  the  parents  of 
criminals  almost  always,  and  Dr.  Pauline  Tarnowsky,  J 
who  has  made  careful  investigation  into  the  mental 
and  physical  development  of  the  prostitute,  found  an 
alcoholic  parentage  in  82.66  per  cent,  of  150  women 
of  this  class  in  St.  Petersburg  whose  ancestry  she  was 
able  to  follow. 

Of  course  it  may  be  said  that  example  and  edu- 
cation in  the  home  of  the  drunkard  may  account  for 
much  of  the  criminality  occurring  in  the  children  of 
drunken  parents ;  but,  as  Prosper  Lucas  says,  in  these 
heritages  of  crime  example  and  education  are  only 
secondary  and  auxiliary  causes,  and  the  true  first  cause 
is  hereditary  influence ;  as  education,  example,  and 
compulsion  would  fail  to  make  a  musician,  an  orator, 
or  a  mathematician  in  default  of  inherited  capacity,  so 
they  would  fail  to  make  a  thief. 

As  to  the  amount  of  insanity,  phthisis,  epilepsy,  &c., 
met  with  in  parents  and  relatives  of  the  criminal,  the 
evidence  is  almost  as  overpowering  as  that  relating  to 
alcoholism.  Dr.  Virgilio  states  that  32  per  cent,  of 
the  whole  criminal  population  of  Italy  have  inherited 

*  Havelock  Ellis  in  "The  Criminal," 

t  "  Les  Habitues  des  Prisons  de  Paris,"  1890. 

t  "  Etude  Anthropomdtrique  sur  les  Prostitutes  et  les  Voleuses." 

§  Op.  tic. 


INSTINCTIVE  CRIMINALITY.  293 

tlieir  criminal  tendencies  from  their  ancestors.  "  Of 
the  inmates  of  the  Elmira  Reformatory  499,  or  13.7 
per  cent.,  have  been  of  insane  or  epileptic  heredity. 
Of  233  prisoners  at  Auburn,  New  York,  23.03  per 
cent,  were  clearly  of  neurotic  (insane,  epileptic,  &c.) 
origin;  in  reality  many  more.  .  .  .  Eossi  found  five 
insane  parents  in  7 1  criminals,  six  insane  brothers  and 
sisters,  and  14  cases  of  insanity  among  more  distant 
relatives.  Kock  found  morbid  inheritance  in  46  per 
cent,  of  criminals.  Marro,  who  has  examined  the 
matter  very  carefully,  found  the  proportion  77  per 
cent.  .  .  .  He  found  that  an  unusually  large  propor- 
tion of  the  parents  had  died  from  cerebro-spinal 
diseases  and  from  phthisis.  Sichard,  examining  nearly 
4000  German  criminals  in  the  prison  of  which  he 
is  director,  found  an  insane,  epileptic,  suicidal,  and 
alcoholic  heredity  in  36.8  per  cent,  incendiaries,  32.2 
per  cent,  thieves,  28.7  per  cent,  sexual  offenders,  23.6 
per  cent,  sharpers."  *  In  Russia  Dr.  Pauline  Tarnowsky 
found  a  phthisical  parentage  in  no  less  than  44  per 
cent,  of  prostitutes,  while  epilepsy  in  the  parents  stood 
at  6  per  cent,  t 

If  further  evidence  were  wanting  of  the  close  rela- 
tionship existing  between  the  insane  and  the  criminal, 
surely  it  is  to  be  found  in  the  fact  that  no  less  than 
32  per  cent,  of  all  the  persons  convicted  of  wilful 
murder  in  England  and  Wales  during  the  ten  years 
1879-1888  were  found  insane,  and  that  another  32 


Havelock  Ellis,  op.  cit. 
t  Op.  cit. 


294  MARRIAGE  AND  DISEASE. 

per  cent,  had  their  sentences  commuted — a  large 
proportion  on  the  ground  of  mental  weakness — leaving 
only  a  third  of  those  actually  sentenced  to  death  to 
undergo  the  last  penalty  of  the  law. 

From  all  this  it  is  clear,  or  it  should  be,  that  the 
instinctive  criminal  is  as  much  sinned  against  as 
sinning ;  that,  as  Plato  said,  "  the  wicked  are  wicked 
because  of  their  organisation  and  education,  and  their 
parents  and  instructors  deserve  punishment  rather 
than  they.'*  It  is  difficult  to  look  upon  the  criminal, 
who  offends  against  the  laws  we  have  framed  for  the 
guidance  of  men  and  women  in  our  social  system, 
as  the  involuntary  agent  of  a  tyrannous  fate.  But  if 
we  will  only  recognise  the  fact  that  volitional  power 
depends  as  much  upon  the  organisation  and  healthy 
working  of  the  higher  nervous  centres,  as  does  the 
power  of  exercising  any  intellectual  quality  whatever, 
our  way  is  clear.  Once  thus  far,  having  passed  the 
dangerous  narrows  of  "  free  will,"  we  can  clearly  see 
that  the  maniac  who  does  murder  at  the  command 
of  a  voice  from  heaven,  his  brother,  who  hangs  him- 
self without  reasonable  cause,  his  sister,  who  takes  to 
prostitution  and  glories  in  her  shame,  and  the  other 
member  of  the  family  who  is  impelled  to  repeated 
acts  of  theft  or  violence,  are  equally  guilty,  or  equally 
the  unhappy  victims  of-  a  vicious  organisation.  The 
thin  end  of  this  wedge  has  already  been  introduced, 
in  the  recognition  by  our  courts  of  the  dipsomaniac 
and  the  kleptomaniac,  even  though  we  are  only  ablo 
as  yet  to  recognise  such  faulty  organisation  in  those 


INSTINCTIVE  CRIMINALITY.  295 

having  good  clothes  and  friends.  But  how  long  it  will 
take  to  drive  it  home,  and  cleave  the  prejudice  of 
centuries,  one  hardly  dares  to  prophesy. 

The  records  of  our  criminal  courts  prove  con- 
clusively that  the  various  legal  pains  and  penalties 
have  no  deterrent  effect  whatever  upon  the  instinctive 
criminal ;  they  have  no  more  effect  upon  him  than 
had  the  chain  and  the  whip  upon  the  ravings  and 
violence  of  the  maniac  of  fifty  or  a  hundred  years 
ago.  Why  then  continue  them  ?  It  would  be  more 
humane  and  Christian-like,  having  recognised  the 
perverted  moral  instincts  of  criminals,  to  save  them 
from  themselves,  and  at  the  same  time  protect 
society,  by  secluding  them  at  once  and  finally  from 
that  society  with  which  they  are  organically  unfitted 
to  mix. 

Dr.  Maudsley  says : — "  It  would,  perhaps,  in  the 
end  make  little  difference  whether  the  offender  were 
sentenced  in  anger,  and  sent  to  the  seclusion  of 
prison,  or  were  sentenced  more  in  sorrow  than  in 
anger,  and  consigned  to  the  same  sort  of  seclusion 
under  the  name  of  an  asylum.  The  change  would 
probably  not  lead  either  to  an  increase  or  to  a 
decrease  in  the  number  of  crimes  committed  in  a 
year."  *  But  on  the  face  of  it  his  argument  is  bad. 
In  the  first  place,  the  seclusion  of  the  asylum  and 
that  of  the  prison  are  to-day  anything  but  the  same. 
In  the  one  secluded  life  is  made  as  tolerable  as  may 
be,  in  the  other  it  is  made  as  intolerable  as  possible, 
*  "Responsibility  in  Mental  Disease,"  p.  26. 


296  MARRIAGE  AND  DISEASE. 

by  all  means  short  of  cruelty.  In  the  next  place, 
the  institution  of  prolonged  asylum  seclusion,  in  place 
of  repeated  short  imprisonments,  must  have  an  imme- 
diate and  marked  effect  upon  "  the  number  of  crimes 
committed  in  a  year."  And  finally,  the  continued 
seclusion  of  the  instinctive  criminal  would  very 
materially  limit  the  propagation  of  a  most  undesir- 
able class. 

Moreover,  it  would  be  much  more  economical  to 
relegate  the  instinctive  criminal,  upon  whom  incar- 
ceration in  prison  cannot  be  expected  to  have  either 
deterrent  or  curative  effect,  to  the  seclusion  of  some 
asylum  or  industrial  penitentiary  for  good,  than  to 
be  at  the  expense  of  repeated  arrests,  trials,  convey- 
ance to  and  from  prisons,  &c.  Take  the  following 
typical  cases,  which  I  clip  from  the  current  news- 
papers, and  let  any  one  say  whether  it  would  not 
have  been  better  in  the  end,  both  for  the  ratepayer 
and  for  the  criminal,  that  on  the  second  appearance 
of  the  criminal  he  had  been  sentenced  "  to  be 
detained  during  Her  Majesty's  pleasure"  in  some 
industrial  asylum. 

"County  of  London  Sessions,  March  10,  1891. 
H.  P.,  aged  forty-four,  was  indicted  before  Sir  Peter 
Edlin,  Q.C.,  for  breaking  and  entering  a  dwelling- 
house  in  Kensington,  and  stealing  therefrom  two 
watches,  &c.  The  jury  found  the  prisoner  guilty.  A 
very  bad  character  was  given  to  him,  two  previous 
sentences  of  ten  years,  as  well  as  minor  penalties, 
being  proved  against  him.  The  learned  chairman 


INSTINCTIVE  CRIMINALITY.  297 

now  sentenced  him   to  serve   a  further  term   of  ten 
years'  penal  servitude." 

"  Central  Criminal  Court. — A  Record  of  Crime. 
A.  D.,  aged  sixty- four,  pleaded  guilty  to  stealing  two 
pipes  of  the  value  of  £3,  153.  The  interest  in  this 
case  centred  not  so  much  in  the  facts  of  the  present 
offence,  as  in  the  previous  career  of  the  prisoner. 
Mr.  Warburton  said  he  was  a  notorious  criminal,  and, 
in  a  statement  he  had  put  in,  he  admitted  having 
spent  about  twenty-eight  years  of  his  life  in  prison. 
Police  witnesses  were  then  called,  and  they  stated 
that  in  June  1886  the  prisoner  was  convicted  and 
sentenced  to  eighteen  years'  penal  servitude,  but  he 
subsequently  turned  Queen's  evidence,  and  the  sentence 
was  commuted.  Many  other  sentences  of  penal  servi- 
tude were  also  proved,  from  which  it  appeared,  the 
"Recorder  observed,  that  the  prisoner  had  passed  forty 
years  of  his  life  in  penal  servitude.  His  record  was 
one  list  of  crime,  and  he  must  inflict  upon  him 
a  further  sentence  of  five  years'  penal  servitude." 
March  10,  1891. 

"  A  curious  case  was  heard  at  the  Chester  Quarter 
Sessions  yesterday,  when  J.  D.  E.  pleaded  guilty  to 
stealing  a  snuff-box  and  three  spoons  from  the 
Grosvenor  Hotel,  Chester,  and  three  handkerchiefs 
from  a  Chester  outfitter.  When  arrested  the  prisoner 
had  in  his  possession  £9$.  The  Eecorder,  Sir 
Horatio  Lloyd,  said  that  E.  had  been  convicted  ten 
times  before.  For  the  past  twenty-three  years  he 
had  been  doing  nothing  but  stealing  and  spending 
his  time  in  gaol.  The  Kecorder  said  he  had  not  even 

20 


298  MARRIAGE  AND  DISEASE. 

the  excuse  that  he  was  poor.      He  was  sentenced  to 
three  months'  hard  labour."      April  4,  1891. 

Now,  who  will  say  that  it  would  not  have  been 
better  "had  these  men,  on  their  second  or  third  offence, 
been  sent  for  good  to  some  industrial  home  or  asylum  ? 
Clearly  their  punishments  had  had  no  beneficial  effect 
upon  them,  and  their  repeated  sentences  could  only 
be  looked  upon  as  revenge  taken  upon  them  by 
society  because  of  their  offences.  In  the  last  of  the 
three  cases,  after  an  experience  of  such  punishments 
extending  over  the  respectable  term  of  twenty-three 
years,  the  criminal  instinct  was  still  so  strong  that, 
with  £g$  in  his  pocket,  he  could  not  resist  the 
temptation  to  steal  three  spoons  arid  three  handker- 
chiefs !  What  good  we  can  expect  to  accrue  from 
the  further  revengelul  "  three  months "  is  beyond 
contemplation. 

Had  these  three  men  been  sent  to  a  reformatory 
in  their  youth,  and  kept  there,  not  only  would  society 
have  suffered  less,  and  the  country  have  escaped  all  the 
expense  of  repeated  arrests  and  trials,  but  probably  a 
considerable  number  of  children  of  the  criminal  class 
which  are  now  with  us  would  not  have  been  called 
into  being. 

The  following  case  shows  how  hopelessly  irresistible 
is  the  instinct  to  crime  when  strongly  developed : — 

"  At  Marylebone,  yesterday,  William  Readhead,  a 
sharp-looking  little  boy,  aged  eleven,  was  charged  with 
stealing  a  purse  containing  twelve  shillings,  belonging 


INSTINCTIVE  CRIMINALITY.  299 

to  Henry  Smith,  an  organ  tuner,  of  22  Victoria  Road, 
Kilburn.  It  was  shown  that  the  boy  had  no  father, 
and  for  certain  reasons  he,  with  his  brothers  and 
sisters,  had  had  to  be  taken  from  their  mother.  The 
prisoner  had  been  supported  by  Mrs.  Goschen,  the 
wife  of  the  Chancellor  of  the  Exchequer,  and  had 
been  in  the  care  of  a  person  in  the  village  of 
Addington,  near  Croydon ;  but  he  committed  so  many 
thefts  there  that  he  had  to  be  moved  away  from  the 
neighbourhood.  He  was  then  placed  in  the  charge 
of  the  prosecutor  at  Kilburn,  the  object  being  that 
he  should  attend  a  school  in  connection  with  St. 
Augustine's  Church,  and  that  the  vicar,  the  Rev.  Mr. 
Kirkpatrick,  would  have  him  under  his  special  care. 
Since  the  prisoner  had  been  at  Kilburn  he  had 
committed  many  thefts.  A  purse  containing  twelve 
shillings  was  left  on  the  kitchen  dresser  last  Saturday 
night,  and,  according  to  an  explanation  the  prisoner 
had  himself  given,  he  got  up  in  the  night,  took  the 
purse,  and  buried  it  in  the  garden.  On  the  following 
day  he  was  sent  to  church,  and  he  then  absconded, 
taking  the  purse  with  him.  The  next  that  was  heard 
of  him  was  from  a  telegram,  saying  that  he  had  been 
found  loitering  about  the  village  at  Addington,  and 
that  some  of  the  inhabitants  had  taken  him  in  until 
Mr.  Smith  fetched  him.  He  was  afterwards  brought 
back  to  London,  and  given  into  the  custody  of  Detective 
Langford.  The  conduct  of  the  boy  had  been  reported 
to  Mr.  Kirkpatrick  every  quarter,  and  he  was  going 
to  place  the  facts  of  the  case  before  Mrs.  Goschen 
shortly.  Mr.  de  Rutzen  remanded  the  boy  to  the 
workhouse,  in  order  that  the  reverend  gentleman 
might  attend  the  Court." — Times,  January  7,  1891. 


300  MARRIAGE  AND  DISEASE. 

In  this  case  it  was  not  hunger,  or  want,  or  example 
or  trying  temptation  that  caused  the  boy  to  steal. 
It  was  what  the  Americans  would  call  pure  "  cussed- 
ness."  In  more  classical,  if  less  expressive  language, 
thieving  with  him  was  an  irresistible  instinct  which  he 
was  impelled  to  gratify  on  every  possible  opportunity. 
In  the  glimpse  we  have  of  the  family  we  find,  as  we 
would  expect,  a  bad  heredity — immorality,  and  what 
else  we  know  not,  on  both  sides. 

What  the  career  before  this  unfortunate  child  may 
be  we  cannot  tell.  It  is  possible  he  may  become  a 
"  record  breaker "  in  the  way  of  criminal  convictions, 
and  beat  the  record  of  the  woman  who  was  sent  to 
prison  at  Liverpool  recently,  for  the  two  hundred- 
and- eighteenth  time.  But  of  one  thing  we  may  be 
certain,  and  that  is,  that  upon  him  imprisonment  will 
have  neither  deterrent  nor  reformatory  effect,  while  it 
will  but  poorly  protect  society  against  his  anti-social 
instincts.  His  life  will  be  one  long  game  of  hide- 
and-seek  between  himself  and  justice.  Society  will 
suffer  much,  and  he  will  suffer  more.  What  is  needed 
in  such  cases  is  not  punitive  imprisonment,  which 
does  not  improve  the  sufferer,  and  which  degrades 
those  whose  disagreeable  duty  it  is  to  carry  it  out, 
but  lifelong  seclusion  in  some  comfortable  asylum, 
where  he  may  spend  as  happy  a  life  as  his  defective 
organisation  will  permit,  and  which  will  ensure  his 
leaving  no  heirs  behind. 


CHAPTER  XXI. 

SOME   OF   THE  LESS   IMPORTANT  HEREDITARY   AFFECTIONS. 

MANY  other  pathological  characters  besides  those 
noticed  in  the  previous  pages  are  transmitted  heredi- 
tarily. Most  of  them  have  already  been  mentioned 
incidentally,  in  one  or  other  of  the  foregoing  chapters, 
but  perhaps  a  few  words  might  be  said  upon  two  or 
three  of  the  more  important  of  them. 

ASTHMA. — This  very  common  and  distressing  malady 
is  distinctly  hereditary.  Observers  differ  as  to  the 
proportion  of  cases  in  which  hereditary  taint  is  to  be 
found,  but  it  may  be  taken  that  at  least  50  per 
cent,  of  all  cases  occurring  arise  from  hereditary  pre- 
disposition. 

The  disorder  is  much  more  frequently  met  with 
in  men  than  in  women,  about  80  per  cent,  of  all 
persons  attacked  being  males. 

The  asthmatic  are  generally  thin  and  gaunt,  with 
round  shoulders  and  a  peculiar  circular,  or  barrel- 
shaped  chest.  This  distorted  form  of  chest  is  often 
inherited,  and  seen  in  infants  the  children  of  asthmatic 
parents,  among  whom  it  is  not  at  all  strange  to  meet 
with  the  spasmodic  attacks  of  the  disease  itself. 


302  MARRIAGE  AND  DISEASE. 

Asthma  is  very  closely  allied  to  the  gouty  and  the 
rheumatic  diatheses,  and  not  a  few  asthmatics  inherit 
gout,  chronic  rheumatism,  or  heart  disease,  as  well  as 
the  spasmodic  affection.  On  the  other  hand,  in  gouty 
families  it  is  a  common  occurrence  for  the  daughters, 
who  are  not  gouty,  to  be  asthmatic,  and  for  these 
to  transmit  gout,  scrofula,  or  rheumatism  to  their 
offspring. 

Asthma  is  also  very  closely  related  to  the  neurotic 
or  insane  diathesis,  the  disease  being  very  common 
in  families  in  which  insanity,  idiocy,  infantile  convul- 
sions, chorea,  and  other  nervous  affections  are  to  be 
found.  In  this  connection  it  may  be  noticed  that  the 
father  of  the  wretched  family  of  suicides,  epileptics, 
and  lunatics,  whose  genealogical  tree  was  given  at 
page  1 8,  died  of  asthma. 

Asthmatics  are  themselves  nervous  and  irritable, 
and  generally  of  the  melancholic  temperament,  as  are, 
also,  their  relatives  and  children,  among  whom  (as  in 
the  above-mentioned  family)  suicides  are  frequent. 

Here  is  the  genealogical  tree  of  another  family  of 
an  asthmatic  father,  one  of  whose  children  was  a  patient 
of  mine : — 


W 

OQ 


II 

£,* 


- 

21 S 


304  MARRIAGE  AND  DISEASE. 

What  may  have  been  the  ancestry  of  this  asthmatic 
father  *we  do  not  know,  but  most  probably  it  was 
strongly  neurotic.  The  degenerate  condition  which 
showed  in  him  as  asthma,  became  fatal  infantile  con- 
vulsions in  six  of  his  children  and  epilepsy  in  another, 
while  the  idiocy  and  tubercular  disease  in  others  of 
his  children  showed  the  deeply  degenerate  character 
of  the  stock. 

We  are  therefore  justified  in  looking  with  grave 
suspicion  upon  the  members  of  all  families  in  which 
this  affection  occurs.  Inquiry  will  prove  that  very 
few  such  families  are  free  from  gout,  heart-disease, 
insanity,  scrofula,  or  other  sign  of  family  degeneration. 

Here  is  the  genealogical  tree  of  the  family  of  an 
asthmatic  mother.  Every  member  of  this  family  I 
knew  intimately : — 

M. - F. 

Healthy.  Asthmatic. 


F.  M.  M. 

Mute.  Scrofulous.  A  drunkard. 

Married,  Died  in  delirium  tremens. 

no  issue.  Married  for  years, 

no  issue. 


"  BLEEDERS." — Of  this  affection  I  have  already 
spoken  at  page  73.  It  is  called  the  "  hsemorrhagic 
diathesis,"  and  consists  of  an  abnormal  condition  of 
the  blood-vessels,  or  the  blood,  or  of  both,  whereby  the 
slightest  cut  or  scratch  is  followed  by  bleeding  so 
profuse  and  uncontrollable  as  to  frequently  prove  fatal. 
Death  has  followed  such  innocent  operations  as  leech- 
ing, vaccination,  or  the  extraction  of  a  tooth ;  indeed, 


LESS  IMPORTANT  HEREDITARY  AFFECTIONS.     305 

this  last  is  the  most  common  cause  of  death  among 
"  bleeders." 

This  abnormal  state  of  the  system  is  purely  heredi- 
tary, and  no  satisfactory  explanation  has  yet  been 
given  as  to  its  cause  or  origin.  Strange  to  say,  it  is  not, 
apparently,  related  to  any  other  hereditarily  transmitted 
abnormal  condition.  Another  remarkable  and  unex- 
plained fact  concerning  this  condition  is,  that  the  Jews 
appear  to  be  specially  liable  to  it.  Drs.  J.  Wickham 
Legg,  Finlayson,  and  others  have  studied  this  diathesis 
most  carefully,  but  as  yet  nothing  has  been  discovered 
to  explain  why  the  condition  should  exist  at  all. 

This  hsemorrhagic  diathesis  is  almost  wholly  con- 
fined to  men,  for  the  reason  given  at  page  73,  viz., 
that  it  would  be  impossible  for  a  woman  to  survive 
the  functions  of  mature  womanhood  in  whom  this 
abnormal  condition  was  active.  The  character  is, 
however,  constantly  transmitted  through  the  female 
members  of  "  bleeder  "  families  to  their  progeny,  which 
clearly  shows  that  although  the  character  is  not  active 
in  these  women,  it  is  present  in  a  latent  form.  This  is 
well  exemplified  in  the  following  family,  whose  history 
is  recorded  by  Dr.  Lessen  and  quoted  by  Sir  W.  Turner. 
In  this  family  the  affection  is  traced  through  three  gene- 
rations :  not  a  single  female  member  of  the  family  was 
affected,  yet  in  the  second  generation  no  less  than  thirteen 
sons  of  two  of  the  females  of  the  family  were  bleeders. 

In  this  family  tree  the  members  affected  are  repre- 
sented by  capital  letters,  those  not  affected  by  small 
letters : — 


PS 

B 


LESS  IMPORTANT  HEREDITARY  AFFECTIONS.     307 

It  is  to  be  noticed,  that  although  only  one  of  four- 
teen sons  of  the  third  generation  escaped,  only  one  of 
nine  sons  in  the  next  generation  was  a  bleeder.  This 
happy  state  of  things  was,  in  all  probability,  due  to 
reversion  to  the  healthy  type  taking  place  in  conse- 
quence of  intermarriage  with  healthy  persons. 

All  that  need  be  said  of  this  hereditary  affection  is, 
that  "  women  of  '  bleeder '  families  should  certainly 
not  be  permitted  to  marry."  * 

COLOUR-BLINDNESS. — This  is  another  abnormal  con- 
dition which  is  in  almost  all  cases  hereditary,  yet  is 
not,  so  far  as  has  been  ascertained,  associated  with  or 
allied  to  any  other  hereditarily  transmitted  abnormal 
state.  Like  the  hsemorrhagic  diathesis,  it  is  largely 
confined  to  the  male  sex,  though  not  so  exclusively  so 
as  that  disorder.  It  is  found  in  3  to  5  per  cent,  of  the 
whole  male  population,  but  in  only  .2  per  cent.,  or  less, 
of  the  female. 

This  diseased  condition,  as  its  name  implies,  con- 
sists of  an  inability  to  distinguish  the  various  colours 
one  from  another.  Bed  and  green  and  other  comple- 
mentary colours  are  most  commonly  confused.  Blind- 
ness to  all  colours  is  rare,  but  in  some  few  cases  black 
and  white  only  are  distinguishable. 

This  insensibility  to  colour  arises  from  an  abnormal 
condition  of  the  retina,  and  that  this  is  a  degenerate 
condition  is,  I  think,  proven  by  the  fact  that  blindness 
to  colours,  exactly  as  we  find  it  in  the  congenital  cases 
at  present  under  consideration,  occurs  in  the  earlier 
*  J.  Wickham  Legg,  F.R.C.P.,  in  "Quain's  Diet,  of  Medicine." 


308  MARRIAGE  AND  DISEASE. 

stages  of  most  cases  of  progressive  degeneration  of 
the  optic  nerve.  Unlike  the  hereditary  affection,  the 
colour-blindness  of  decay  of  the  optic  nerve  generally 
goes  on  to  total  blindness. 

As  in  the  case  of  the  haemorrhagic  diathesis,  this 
blindness  to  colours,  although  rarely  found  in  women, 
is  regularly  transmitted  through  female  members  of 
colour-blind  families  to  their  offspring,  their  daughters, 
like  themselves,  generally  escaping  the  blight.  The 
following  family  history  offers  a  good  example  of  the 
usual  course  followed  in  the  transmission  of  this 
abnormal  condition  of  the  visuary  apparatus.  It  is  re- 
lated by  Dr.  Horner,  who  was  able  to  follow  the  colour- 
blindness through  no  less  than  seven  generations. 

Those  colour-blind  are  represented  by  capital  letters, 
those  not  so  affected  by  small  letters : — 

M. 

I 


*. 


i 

i 
i 

i 

I 

£ 

-K 

A 

IT) 

1      i       1     TT~I       1    1    1 

/.      AL      M.  M.  /.  /.       M.  /.  /.  . 

).! 

It  is  to  be  noticed,  that  the  second,  fourth,  and  sixth 
generations  of  this  family  were  entirely  female,  and  in 
these  the  abnormal  character  did  not  appear.  In  the 
seventh  generation,  made  up  of  nine  males  and  nine 


LESS  IMPORTANT  HEREDITARY  AFFECTIONS.    309 

females,  all  the  females  escaped,  while  eight  of  the 
nine  sons  were  colour-blind. 

CATARACT. — This  is  another  diseased  condition  of 
the  eye  which  is  distinctly  hereditary.  Like  colour- 
blindness, it  is  much  more  frequently  met  with  in 
males  than  in  females,  but,  unlike  colour-blindness,  it 
is  intimately  related  with  another  degenerate  condi- 
tion, viz.,  the  neurotic  diathesis. 

This  imperfection,  which  consists  of  degenerative 
changes  in  the  tissues  of  the  lens  of  the  eye,  causing 
opacity  and  consequent  blindness,  is  in  the  usual 
course  of  nature  a  senile  change  :  but  just  as  we  find 
earthy  degeneration  in  the  tissues  of  the  youthful 
criminal,  so  in  some  degenerate  families  we  find 
cataract  in  childhood,  infancy,  and  even  at  birth. 
This  degenerate  condition  of  the  eye  is  very  common 
in  neurotic  families,  and  also  in  those  of  the  scrofu- 
lous and  rheumatic  diatheses.  It  is  a  common  char- 
acter in  the  idiot,  the  imbecile,  and  the  epileptic ;  so 
common  indeed  is  it  in  this  class  that  its  presence  at 
once  attracts  the  attention  of  all  observant  visitors  to 
our  idiot  asylums.  It  is  also  common  among  the  deaf 
and  dumb  and  their  relatives. 

As  I  have  said,  it  appears  much  more  frequently 
in  the  male  members  of  the  family  than  the  female, 
but  it  is  regularly  transmitted  through  the  unaffected 
females  to  their  offspring.  This  is  well  shown  in  the 
following  family  tree,  in  which  Dr.  Appenzeller  follows 
the  blight  through  four  generations : — 


MARRIAGE  AND  DISEASE. 


It 

Cataract. 
1 

i. 

NormaL 
1 

M. 
Cataract. 
1 

J. 

Cataract. 

yOJ. 

Normal. 

I              !                     I 
F.              F.                     M. 
v—  —  ^s~—  '                Cataract. 
Normal. 

i 

NormaL 

A.         J 

Cataract.              •- 

F. 

—  ,  ' 

J     J     il 

J!  •             -E  .             JM.. 

Normal. 


Cataract. 


SQUINT. — This  is  another  imperfection  of  the  ocular 
apparatus  which  is  very  frequently  hereditary.  Like 
cataract,  it  is  very  common  among  idiots,  imbeciles, 
and  epileptics.  Its  presence  points  to  nervous  dis- 
order, central  or  otherwise,  and  must  be  looked  upon 
in  all  cases  where  it  is  not  the  result  of  local  injury, 
not  simply  as  a  disfigurement,  but  as  a  sign  of  the 
presence  of  the  neurotic  diathesis. 

The  eye  is  more  intimately  connected  with  the 
brain  than  almost  any  other  organ  in  the  economy 
except  the  ear,  and  where  disease  or  other  imperfect 
conditions  of  the  nervous  centres  are  met  with,  the 
eye  generally  shows  imperfect  development,  deformity, 
or  degenerative  change.  Indeed,  it  is  the  exception 
rather  than  the  rule  to  find  perfect  eyes  among  idiots, 
imbeciles,  and  others  in  whom  the  brain  is  ill-developed 
or  diseased. 

DIABETES. — This  is  another  disease  which  is  very 
commonly  hereditary.  Like  asthma  and  the  eye 
affections  just  noticed,  it  is  closely  allied  to  the 
nervous  diathesis.  It  is  the  rule  to  find  epileptic  or 


LESS  IMPORTANT  HEREDITARY  AFFECTIONS.     311 

imbecile  members  in  the  family  of  the  diabetic  person.* 
Diabetes  is  also  very  common  in  families  in  which 
active  insanity  attacks  some  members.  Drs.  Maudsley, 
Clouston,  and  others  have  pointed  out  this  relationship 
between  insanity  and  diabetes.  Dr.  Savage,  in  a 
paper  which  he  read  before  the  Medical  Society  of 
London  in  November  1890,  said  that  after  a  study  of 
forty  patients  in  Bethlehem  Hospital  for  the  insane  who 
had  diabetic  relations,  and  ten  patients  who  were  at 
once  diabetic  and  insane,  he  came  to  the  conclusion 
that  diabetes  and  insanity  were  closely  related,  and 
that  in  such  families  the  form  of  mental  disorder  most 
common  was  melancholia. t 

This  is  another  of  the  diseases  which  attack  the 
males  of  affected  families  much  more  frequently  than 
the  females,  the  proportion  of  males  to  females  being 
about  three  to  one.  In  males  it  generally  makes  its 
appearance  between  thirty  and  forty  years  of  age,  but 
in  females  much  earlier,  commonly  between  ten  and 
thirty  years. 

All  families  in  which  diabetes  occurs  should  be 
looked  upon  with  suspicion,  and  should  epilepsy, 
idiocy,  insanity,  or  deaf-mutism  also  have  appeared 
in  the  family,  it  is  a  very  grave  question  whether 
marriage  should  be  ventured  upon. 

BRIGHT'S  DISEASE. — This  disease,  which  depends 
upon  degenerative  tissue-changes  in  the  kidneys,  is 
often  a  hereditary  affection.  It  is  met  with  in  various 

*  Alexander  Silver,  in  "  Quain's  Diet,  of  Medicine." 
t  Society's  Transactions,  1890. 


312  MARRIAGE  AND  DISEASE. 

forms  in  rheumatism,  gout,  syphilis,  cancer,  phthisis, 
and  heart-disease,  and  is  most  certainly  a  constitu- 
tional disease.  In  some  cases,  as  in  chronic  alcohol- 
ism, it  appears  to  arise  from  actual  irritation  of  the 
kidneys  by  the  large  quantities  of  alcohol  they  are 
continually  called  upon  to  cast  out  of  the  system ; 
but  even  in  these  cases  I  prefer  to  look  upon  it 
as  a  constitutional  affection,  and  class  the  tissue 
degeneration  in  the  kidney  of  the  drunkard  in  the 
same  category  with  that  which  is  found  in  his  brain, 
heart,  liver,  blood-vessels,  and  other  tissues  of  the 
body. 

Dr.  Dickinson  brought  a  curious  case  of  Bright's 
disease  before  the  Pathological  Society  of  London  in 
1889.  In  this  case  he  was  able  to  trace  the  disease 
through  at  least  four  generations.  It  affected  fourteen 
out  of  twenty-three  persons,  and  was  traceable  also 
in  a  collateral  branch  of  the  family.  Not  the  least 
interesting  fact  in  this  case  was  that  the  portraits 
of  the  family,  which  have  been  preserved  since  the 
time  of  Edward  IV.,  showed  the  pallor  peculiar  to 
persons  suffering  from  disease  of  the  kidney.  This, 
however,  I  take  to  have  arisen  from  changes  in  the 
pigments  used  by  the  artists,  rather  than  from  the 
existence  of  the  disease  in  these  early  ancestors,  as  such 
a  disease  would  assuredly  exterminate  a  family  before 
so  many  generations  had  come  and  gone.* 

There  are  many  other  disease  tendencies  and  bodily 
imperfections,  among  which  might  be  mentioned  al- 

*  British  Medical  Journal,  May  II,  1889. 


LESS  IMPORTANT  HEREDITARY  AFFECTIONS.     313 

binism,  heart-disease,  club-foot,  hare-lip,  cleft-palate, 
stuttering,  &c.,  which  are  regularly  and  commonly 
transmitted  in  families,  but  they  call  for  no  special 
notice  here.  They  follow  the  same  laws  of  trans- 
mission as  do  other  hereditary  characters,  and  the 
frequency  with  which  they  appear  in  the  offspring 
depends  upon  how  deeply  they  have  been  impressed 
upon  the  organism  by  repeated  transmission,  and  what 
chance  is  given  the  vis  medicatrix  natures  in  wise 
marriages  of  leading  back  to  the  original  healthy 
stock.  Of  course,  in  families  in  which  any  of  these 
or  other  imperfections  appear,  the  intermarriage  of 
even  very  distant  relatives  should  be  prohibited. 


21 


INDEX. 


ABERNETHY'S  receipt  for  the  gout, 

217. 
Abnormal    fecundity    hereditary, 

63. 

Acquired  characters,  33 ;  are  trans- 
mitted, 15,  36,  39,  40;  in  the 
Jews,  52;  syphilis,  145. 

Action  of  environment,  28 ;  on 
man,  30 ;  on  germ  cell,  35 ; 
understood  by  Jacob,  30. 

Advice  as  to  marriage,  in  insanity, 
96,  98,  ill,  113;  in  drunken- 
ness, 127  ;  in  epilepsy,  140;  in 
syphilis,  159;  in  deaf  mutism, 
172  ;  in  cancer,  193  ;  in  tuber- 
cular disease,  212;  in  gout,  226; 
in  rheumatism,  240 ;  in  youth 
and  old  age,  264 ;  in  bleeders, 
307;  in  diabetes,  311. 

Age   at  which  diabetes  appears, 

3". 

Aged  parents,  Children  of,  257, 

259- 

Aitken,  Sir  Wm.,  on  family  his- 
tories, 72,  272 ;  on  marriage  of 
insane,  8 1  ;  on  cancer,  175. 

Albertatti  on  deaf  mutism,  169. 

Alcohol  in  gout,  216. 

Alibert  on  cancer,  183. 

All  degenerations  related,  48. 

America,  Deaf  mutism  in,  169 ; 
Cancer  in,  180. 


Americans,  Sir  Wm.  Turner  on, 

39; 

Ancients,  their  theory  of  epilepsy, 
130 ;  Marriage  laws  of,  267, 
276. 

Ancon  sheep,  276. 

Anstie,  Dr.,  on  consanguineous 
marriages,  269. 

Appenzeller,  Dr.,  on  transmission 
of  cataract,  310. 

Aristotle  on  children  of  early  mar- 
riages, 248. 

Asthma,  301  ;  hereditary,  301  ; 
more  common  in  males,  301  ; 
allied  to  other  degenerations, 
302,  304. 

Atavism,  72  >  Sexual,  73  ;  com- 
mon in  mental  and  moral 
characters,  74. 

Atrophy  in  civilised  man,  of  fifth 
toe,  38  ;  of  jaw,  38. 

BACHS,  The,  Consanguineous  mar- 
riages among,  275. 

Baillarger  on  gravity  of  parental 
insane  taint,  ill. 

Barker,  Dr.  Fordyce,  on  cancer  in 
America,  180. 

Barren  women  often  cancerous, 
188. 

Beach,  Dr.  Fletcher,  on  drunken- 
ness and  idiocy,  123  ;  on  trans- 


3i6 


INDEX. 


mutability  of  the  neuroses,  137  ; 
on  tubercular  disease  and  idiocy, 
204. 

Bell,  Prof.,  on  deafmutism.  169. 

Blackmailing  by  quacks,  159. 

"Bleeders,"  304;  only  ina.es,  73, 
305  ;  among  the  Jews,  305  ;  A 
family  of,  306. 

Both  parents  neurotic  :  its  effect, 
108,  no. 

Breeding,  healthy  children,  4 ; 
domestic  animals,  13 ;  slaves, 
13  ;  "in  and  in,"  its  effect,  58. 

Bright's  disease,  311  ;  often  here- 
ditary, 311;  related  to  other 
degenerations,  312;  in  chronic 
alcoholism,  312  ;  transmitted 
through  four  generations,  312. 

Brown -S^quard  on  transmission  of 
acquired  epilepsy,  40. 

Burton  on  hereditary  deafmutism, 
165. 

CANCER,  175  ;  Varieties  of,  176  ; 
Increase  of,  177  ;  in  Ireland, 
180;  in  Scotland,  179;  in 
America,  180  ;  its  cause,  180; 
follows  injuries,  182 ;  a  de- 
generation, 181  ;  allied  to  all 
other  degenerations,  181,  184, 
1 86  ;  cause  of  its  increase,  183  ; 
not  inoculable,  183 ;  trans- 
mitted, 185,  191  ;  transmuted, 
49,  184,  1 86 ;  a  cause  of  steril- 
ity, 1 88  ;  a  disease  of  age,  189 ; 
hereditary,  190. 

Cancerous  diathesis,  181  ;  Mar- 
riage of  those  of  the,  193. 

Cantlie,  Mr.,  on  degeneration  of 
Londoners,  31,  41. 

Cataract,  309 ;  a  hereditary  de- 
generation, 309  ;  allied  to  other 
degenerations,  309 ;  transmitted 
through  four  generations,  310. 


Causes  of  variation  in  the  family 
type,  32. 

Characters,  gain  fixity  with  age, 
51  ;  lately  acquired  frequently 
lost,  5 1  ;  vary  in  potency,  56  ; 
degenerate,  all  allied,  48. 

Children  of  drunkard,  126;  of 
immature,  245,  248,  259;  of 
the  aged,  257,  259. 

Child's  inheritance,  II  ;  child 
marriages,  244. 

Chorea,  234 ;  and  rheumatism, 
234  ;  and  the  neurotic,  235. 

Civilisation,  its  effect,  I. 

Clouston,  Dr.  T.  S.,  on  dipso- 
mania, 116;  on  epilepsy,  130, 
136 ;  on  deafmutism,  161  ;  ou 
tubercular  disease  and  insanity, 
204 ;  on  rheumatism  and  in- 
sanity, 233  ;  on  early  marriages, 
243  ;  on  degeneration  in  crimi- 
nals, 286. 

Collateral  heredity,  74. 

Colour-blindness,  307 ;  hereditary, 
307  ;  in  disease,  307 ;  Genea- 
logical tree  of,  308. 

Commissioners  in  Lunacy,  Report 
of,  82  ;  on  hereditary  character 
of  insanity,  92 ;  on  drunken- 
ness a  cause  of  insanity,  126; 
on  epilepsy  in  the  insane,  139. 

Concealment  of  insanity  in  family, 
90. 

Consanguineous  marriages,  266 ; 
always  dangerous,  278. 

Constant  environment  antago- 
nistic to  reversion,  62. 

Consumptive,  The,  described, 
198. 

Copland,  Dr.,  on  rheumatism  and 
chorea,  234. 

Crime,  among  modern  women, 
223,  290 ;  transmitted,  288 ; 
related  to  idiocy  and  insanity, 


INDEX. 


317 


287  ;  Instinctive,  280 ;  in  de- 
caying families,  289. 

Criminal,  The,  instinct  trans- 
mitted, 16,  288,  290 ;  scrofulous, 
206;  Parentage  of,  262,  291, 
300 ;  type,  283  ;  ugly,  287 ; 
instinctive,  a  moral  imbecile, 
285  ;  ill-developed,  285 ;  Cha- 
racters of,  287 ;  Records  of, 
296;  instinctive,  causes  of,  291 ; 
Proposed  treatment  of,  296, 
298,  300. 

Criminal    Law  Amendment  Act, 

253- 
Criminality,  varies  in  the  sexes, 

290  ;  in  children,  298. 
Criminologists,  English,  284. 
"Crossing,"  its  effect,  47,  54,  57, 

277,  278. 

Cullen,Dr.,onheredityin'gout,2l9. 
Cultivation,  of  hereditary  disease, 

I ;  of  the  unfit,  21,  142. 

DALTONISM,  307. 

Danger  of  intermarriage,  of  the 
neurotic,  98  ;  of  the  syphilitic, 
146. 

Darwin,  George,  on  consanguine- 
ous marriages,  269 ;  Prof. 
Charles,  his  theory  of  Pange- 
nesis,  12;  on  transmission  of 
acquired  characters,  42. 

Deafmutism,  161  ;  hereditary, 
162 ;  Intermarriage  of,  161, 
172;  Ribot  on,  163;  a  dege- 
neration, 162  ;  percentage  here- 
ditary, 164 ;  allied  to  other 
degenerations,  163,  169;  Irish 
Census  Commissioners  on,  164  ; 
Scotch  Lunacy  Commissioners 
on,  1 66 ;  Prof.  Bell  on,  169 ; 
Causes  of,  171. 

Deception  practised  by  those  of 
insane  family,  88,  90,  112. 


Deformities,  in  children  of  syphi- 
litic, 150  ;  in  deaf-mutes,  169. 

Degeneration,  from  city  life,  30, 
40  ;  among  Londoners,  31,  41  ; 
from  city  life  transmitted,  40; 
from  drunkenness,  1 24  ;  in  off- 
spring of  aged  and  immature, 

•  257,  264 ;  in  criminals,  283, 
285  ;  in  parents  of  criminals, 
292;  in  asthmatic  stock,  302, 

304- 

Degenerations  all  closely  allied 
and  transmutable,  48. 

Dementia  from  epilepsy,  131. 

Demoniacal  possession,  130. 

De  Quatrefages  quoted,  33. 

Diabetes,  310;  often  hereditary, 
3 IO  ;  allied  to  the  neurotic,  311. 

Diagonal  heredity,  69,  71. 

Dickinson,  Dr.,  on  heredity  in 
Bright's  disease,  312. 

Dipsomania,  116,  125. 

Direct  heredity,  67,  71. 

Disappearance  of  wisdom  teeth  in 
civilised  man,  38. 

Disease,  hereditary,  I  ;  trans- 
mitted, 3  ;  cannot  be  repeated 
indefinitely,  20 ;  an  acquired 
character,  36,  53  ;  transmutable, 

99- 

Diseases  allied  to  insanity,  99. 

Dogs,  All,  from  one  stock,  42. 

Dontrebente  quoted,  109. 

Down,  Dr.  Langdon,  206. 

Drunken  parentage,  its  effect,  291. 

Drunkenness,  116;  a  cause  of 
idiocy,  76,  123;  degrading,  119; 
in  woman,  119;  Penalties  use- 
less against,  121  ;  a  cause  of 
deformity,  123  ;  in  Sweden  and 
Norway,  124;  is  a  degenera- 
tion, 124;  Family  history  of, 
125  ;  Two  forms  of,  125  ;  trans- 
mutable,  126;  in  mother  most 


318 


INDEX. 


dangerous,  128 ;  a  cause  of 
crime,  291. 

Duckworth,  Sir  Dyce,  on  gout, 
219. 

Duncan,  Dr.  Matthews,  on  pre- 
mature marriage,  250. 

EARLY  marriages,  243 ;   Children 

of,  245,  248. 
Echeverria  on  hereditary  epilepsy, 

135- 

Education  on  heredity  required,  5. 

Elam,  Dr.  Charles,  quoted,  247. 

Ellis,  Havelock,  quoted,  169,  261, 
284,  292,  293. 

Engaged  man,  the,  128. 

Environment,  produces  variation, 
28  ;  modifies  individual,  30  ; 
modifies  community,  31,  272  ; 
modifies  moral  and  intellectual 
as  well  as  physical,  32  ;  modi- 
fies germ  cell,  35  ;  aids  in  fixing 
new  character,  58. 

Epilepsy,  1 30 ;  acquired  and  trans- 
mitted, 40  ;  combined  with  in- 
sanity in  parents,  108  ;  ends  in 
dementia,  131 ;  Dangers  of,  131  ; 
hereditary.  134;  found  in  most 
degenerate  families,  136,  139; 
transmutable,  135  ;  allied  to  all 
other  neuroses,  137  ;  a  degene- 
ration, 138  ;  among  idiots,  139  ; 
among  insane,  139;  Deaths 
from,  140. 

Epileptic,  mania,  132  ;  dementia, 
132. 

Epileptics,  insane,  133  ;  Mar- 
riage of,  141  ;  Ancient  laws 
against  marriage  of,  141. 

Esmarch,    Prof,   von,  on   cancer, 

183- 

Esquirol,  on  melancholia,  104 ; 
on  epilepsy,  133;  on  heredity 
in  epilepsy,  135. 


Estimate,  To,  gravity  of  hereditary 
insane  taint,  107,  III. 

Evolution,  Heredity  a  part  of,  65. 

Extinction  of  the  degenerate^  1 6, 
19. 

Extreme  variations  cannot  be  per- 
petuated, 26,  45,  51. 

FACE-READING,  281. 

Falret  on  suicide,  102. 

Family,  Extinction  of,  16  ;  Tree 
of  a  decaying,  1 8,  303  ;  pattern, 
26 ;  tree  showing  transmuta- 
bility  of  pathological  characters, 
49  ;  characters  vary  in  potency, 
56 ;  histories,  their  value,  72  ; 
histories  of  insane,  85,  97  ;  his- 
tories concealed,  97  ;  history  of 
drunken  stock,  125  ;  of  deaf- 
mutes,  1 66;  histories  of  the  cri- 
minal, 288,  289;  of  "Bleeders," 
306;  of  colour-blind,  308;  with 
cataract,  310;  with  Bright's 
disease,  312;  history  of  asth- 
matics, 303,  304. 

Feeble  liable  to  tubercular  disease, 
209. 

Feeding  and  gout,  216. 

Female  criminals  increasing,  290. 

Finlayson,  Dr.,    on    "  Bleeders," 

73,  305- 

Fixity  secured  by  repeated  trans- 
mission, 51,  56,  58,  59. 

Flint,  Dr.  Austin,  on  hereditary 
phthisis,  79. 

Fournier,  Prof.,  on  hereditary 
syphilis,  151  ;  on  marriage  of 
the  syphilitic,  160. 

Freedom  of  the  subject,  94. 

Free  will,  294. 

GARROD,  Sir  Alfred,  on  heredity 
in  gout,  219  ;  his  history  of  a 
gouty  family,  225. 


INDEX. 


319 


Gemmules,  12. 

General  paralysis,  107;  in  women, 

222. 

Genius  and  insanity,  74. 

Germ  cell,  35. 

Gossler,  Herr  von,  on  tubercular 
disease  in  cattle,  2IO. 

Gout,  214;  prepotency  in,  62; 
atavism  in,  72  ;  a  disease  of 
civilisation,  214,  217 ;  slowly 
evolved,  220  ;  in  woman,  222  ; 
in  the  poor,  225  ;  a  degenera- 
tion, 223  ;  and  intellect,  225. 

Gouty  described,  218. 

Gowers,  Dr.,  on  epilepsy,  135. 

Gravity  of  hereditary  taint,  how 
estimated,  59,  107. 

Griesinger  on  parentage,  257. 

Grigg,  Dr.,  on  plural  births,  63. 

Gull,  Sir  William,  on  hereditary 
disease,  4 ;  on  cancer  and  scro- 
fula, 184. 

HABITUAL  drunkard,  125. 

Hsemorrhagic  diathesis,  73,  304 ; 
hereditary,  305 ;  among  the 
Jews,  305  ;  latent  in  female, 

73,  305- 

Hammond,  Dr.,  on  suicide,  ico. 

Heart  disease  in  rheumatic,  238. 

Hereditary  disease  a  bar  to  mar- 
riage, 5 ;  affections  intractable, 
117. 

Heredity,  defined,  IO  ;  a  universal 
law,  10 ;  ignored  in  the  breed- 
ing of  children,  13  ;  a  part  of 
evolution,  65 ;  laws  of,  67 ; 
direct,  67,  71  ;  diagonal,  69, 
71  ;  initial,  75  J  °f  influence, 
77  ;  reversional,  72 ;  indirect, 
74  ;  collateral,  74  j  in  insanity, 
8 r,  85  ;  at  corresponding  ages, 
79;  in  general  paralysis,  107; 
in  traumatic  insanity,  106;  in 


epilepsy,  135  ;  in  syphilis,  149  ; 
in  drunkenness,  116;  in  deaf- 
mutism,  162,  166;  in  gout,  219; 
in  cancer,  175,  182  ;  in  crime, 
288 ;  in  "  Bleeders,"  306  ;  in 
colour-blindness,  307  ;  in  cata- 
ract, 309  ;  in  diabetes,  310 ; 
in  Bright's  disease,  312. 
Herpin  on  epilepsy  in  idiocy, 

139- 

Hillier,  Dr.,  on  chorea  and  rheu- 
matism, 234. 

Hippocrates,  on  tubercular  disease, 
194  ;  on  gout,  214  ;  on  gout  in 
woman,  222. 

History  of  families  :  neurotic,  1 8, 
49»  85,  137,  138,  231,  238,  303, 
304  ;  cancerous,  49,  185,  191  ; 
suicidal,  100,  IOI  ;  drunken, 
125;  syphilitic,  151;  epileptic, 
108  ;  gouty,  225  ;  rheumatic, 
231,  238  ;  deaf-mute,  165,  166  ; 
criminal,  288,  289  ;  asthmatic, 
1 8,  303,  304  ;  "  Bleeder,"  306  ; 
colour-blind,  308 ;  with  cata- 
ract, 310. 

Horner,  Dr.,  on  colour-blindness, 
308. 

Howe,  Dr.,  on  idiocy  from  drun- 
kenness, 123. 

How  to  estimate  gravity  of  heredi- 
tary taint,  59,  107,  in. 

Human  porcupine,  The,  71. 

Huss,  Dr.  Magnus,  on  drunken- 
ness in  Sweden,  125. 

Hutchinson,  Mr.  Jonathan,  on 
marriage  of  syphilitic,  159  ;  on 
cause  of  gout,  216,  217;  on  gout 
and  rheumatism,  239. 

Huth,  Mr.  A.  H.,  on  "Marriage  of 
Near  Kin,"  268. 

IDIOCY,  from  drunkea,parents,  76, 
123;  in  Norway  and  Sweden, 


320 


INDEX. 


124 ;  and  crime,  287  ;  and  scro- 
fula, 204. 

Ill-development  of  the  criminal, 
285. 

Immature,  marriage  of  th<»,  243  ; 
offspring  of  the,  245,  247. 

Imprisonment  useless,  against 
drunkenness,  121  ;  against  in- 
stinctive criminality,  295. 

Increase,  of  insanity,  83  ;  of  sui- 
cide, 87  ;  of  crime  among  wo- 
men, 290. 

In-and-in  breeding,  fixes  charac- 
ters, 58 ;  generally  dangerous, 
268. 

Indirect  heredity,  74. 

Inheritance  of  child,  1 1. 

Initial  heredity,  75. 

Insane,  population,  82  ;  Marriage 
of  the,  8 1,  88 ;  Parentage  of  the, 
263. 

In-anity,  81  ;  and  genius,  74 ; 
hereditary,  8 1  ;  Increase  of,  83  ; 
proportion  hereditary,  91  ;  and 
marriage,  96  ;  Prevention  of, 
96  ;  Diseases  related  to,  99  ;  in 
mother,  1 1 1  ;  in  father,  1 1 1 ;  in 
both  parents,  io8-HOj  follow- 
ing injuries,  106 ;  combined 
with  epilepsy  in  parents,  1 08  ; 
transmuted,  137,  288  ;  and  tu- 
bercular disease,  205  ;  and  rheu- 
matism, 231  ;  and  crime,  287  ; 
in  murderers,  293  ;  and  dia- 
betes, 311. 

Instability  of  recently  acquired 
characters,  51. 

Instinctive  crime,  280  ;  a  degene- 
ration, 283  ;  hereditary,  288  ; 
Proposed  treatment  of,  296, 
298  ;  Typical  cases  of,  296. 

Intellectual,  characters  trans- 
mitted, 16  ;  quality  modified  by 
the  environment,  32. 


Intermarriage,  of  pathological 
characters  like  and  unlike 
equally  bad,  48  ;  of  cancerous 
and  neurotic,  49  ;  of  disease, 
6l,  241,  272  ;  of  neurotic,  97, 

108,  231,  238  j  of  insanity  and 
epilepsy,   108  ;  of  insanity,  108, 

109,  HO,  138;  of  drunkenness, 
127  ;  of  deafmutism,  169,  172; 
of    cancer    and     consumption, 
185  ;  of  the  immature,  243  ;  of 
the  aged,  258  ;    of  blood  rela- 
tions,  266  ;  of  criminals,  288  ; 
of  drunken  and  insane,  289  ;  of 
the  degenerate,  313. 

Ireland,  Cancer  in,  180  ;    Mixed 

peoples  in,  278. 
Ireland,  Dr.,  on  epilepsy  in  idiots, 

139. 

Irish  Census  Commissioners  on 
deafmutism,  164. 

JACOB  on  action  of  environment, 
30. 

Jaws  in  savage  and  civilised  man, 
38. 

Jews,  Acquired  characters  in  the, 
52;  Consanguineous  marriages 
among  the,  267  ;  Social  consan- 
guinity rare  among  the,  273  ; 
"  Bleeders  "  among  the,  305. 

Judicious  marriages,  54. 

Jukes  family,  Prostitution  in  the, 
290. 

Just    treatment     of     drunkards, 

122. 

KIDNEY  disease  in  gout,  217. 
Koch,  Prof.,  on  tubercular  disease, 

195- 

Kolk,  Schroeder  van  der,  insan- 
ity and  phthisis,  205. 

Korosi,  M.,  206 ;  on  parentage, 
250,  256,  260. 


INDEX. 


321 


LAMBERT,  Edward,  Case  of,  71. 
Latency  of  family  characters,  73, 

305,  3°8- 

Laurent,  Dr.  E.,  on  parentage  of 
the  criminal,  292. 

Lavater  cited,  281. 

Lawrence,  Sir  William,  on  six- 
fingered  man.  276. 

Laws,  of  heredity,  67 ;  as  to  mar- 
riage, 244,  254. 

Lecky,  Mr.,  on  legislation  against 
syphilis,  156. 

Legg,  Dr.  Wickham,  on  "  Bleed- 
ers," 73,  305,  307. 

Legislation,  against  marriage  of 
insane,  90,  92  ;  against  mar- 
riage of  epileptic,  141  ;  against 
hereditary  disease,  8,  22,  90, 
114;  against  drunkenness,  1 1 8. 

Liability  to  tubercular  disease  in 
man  and  animals,  212. 

Limitation  of  disease  bylaw,  8,  22, 
92,118,  141,  156,244,  254,300. 

Little  toe  in  civilised  peoples.  38. 

Lombroso,  Prof.,  207. 

Long  engagement  useful,  128. 

Lessen,  Dr.,  on  "Bleeders,"  305. 

Lottery  of  marriage,  113. 

Love  not  blind,  6. 

Lucas,  Prosper,  on  reversional 
heredity,  72  5  on  early  mar- 
riages, 248 ;  on  parentage  of 
criminals,  292. 

Lugol,  Dr.,  on  tubercular  disease 
and  insanity.  205. 

Lupus  in  scrofulous,  203. 

Lumbago,  236. 

Lunacy  Commissioners,  Report  of, 
82;  on  heredity  in  insanity,  92  ; 
on  epilepsy  among  insane,  139. 

MADNESS,  Increase  of,  83. 
Mantegazza  on  teeth  of  civilised 
man,  38. 


Marriage,  renounced  because,  of 
hereditary  disease,  6  ;  laws,  7, 
21,  244,  254  ;  should  be  forbid- 
den to,  9,  94  ;  of  the  insane,  74, 
8 1,  88,  96  ;  of  unfit,  170  ;  of  in- 
sane should  be  forbidden,  92  ; 
and  drunkenness,  116,  127;  of 
epileptics,  ancient  laws  against, 
141  ;  of  syphilitic,  159  ;  of  deaf 
mutes,  1 70,  1 72  ;  of  cancerous, 
193;  of  tubercular,  212;  of 
rheumatic,  240  ;  of  the  imma- 
ture, 243  ;  of  the  senile,  256  ; 
The,  contract,  244 ;  and  mo- 
rality, 246  ;  statistics,  252,  264; 
of  relatives,  266  ;  laws  of  an- 
cients, 267  ;  laws  of  Jews,  267  ; 
of  near  kin,  268 ;  of  "  Bleeders," 
307  ;  of  diabetic,  311. 

Marro,  Dr.,  on  parentage,  206, 
250,  256,  260,  262,  291,  293. 

Maternal  taint,  III,  128. 

Maudsley,  Dr.,  on  heredity,  14; 
on  genius,  74  >  °n  marriage  of 
insane,  74 ;  on  city  dwellers, 
40 ;  on  transmission  of  acquired 
characters  40  ;  on  drunkenness 
and  idiocy,  76,  123;  on  conceal- 
ment of  insanity,  91  ;  on  pre- 
vention of  insanity,  96  ;  on  child 
suicide,  103;  on  transmutability 
of  insanity,  206 ;  on  crime,  207; 
on  neuralgia,  236  ;  on  degene- 
ration among  criminals,  285; 
on  moral  feeling,  284 ;  Family 
histories  fr'»m,  289,  290  ;  on 
punishment  of  instinctive  cri- 
minal, 295. 

Medical  Inspector  of  Prisons,  his 
report,  286. 

Melancholia,  103  ;  often  heredi- 
tary, 104  ;  in  the  diabetic,  311. 

Mental  characters  transmitted, 
16. 


322 


INDEX. 


Mixed  races,  277-;  in  southern 
Europe,  277  ;  in  Ireland,  278 ; 
in  Germany,  278. 

Modern  woman,  her  diseases,  222; 
crime  among,  290. 

Modes  of  family  extinction,  1 6, 19. 

Montesquieu  on  early  marriages, 
248. 

Moral  imbecility,  285. 

Moral  nature,  affected  by  environ- 
ment, 32  ;  destroyed  by  drunk- 
enness, 1 19  ;  transmitted,  288. 

Morality,  and  early  marriage,  246 ; 
dependent  on  organisation,  284. 

Morel,  Dr.,  on  drunkenness,  125. 

Mortality,  from  epilepsy,  140; 
from  syphilis,  155  ;  from  can- 
cer, 1 79 ;  from  tubercular  dis- 
ease, 194. 

Murderers,  Parentage  of,  263  ; 
Insanity  among,  293. 

Mutilations  not  transmitted  as  a 
rule,  36. 

NATURAL,  inheritance  of  child,  II ; 
life,  2. 

Nature  obstructed,  3,  141. 

"  Nature's  remedy,"  19. 

Necessity  for  legislation,  re  insa- 
nity, 92;  re  syphilis,  156;  rt 
marriage  laws,  254. 

Neuralgia  and  insanity,  236. 

Neuroses  transmutable,  99. 

Neurotic,  The,  Intermarriage  of, 
97,  108,  109 ;  Advice  as  to 
marriage  of,  96,  113  ;  Family 
histories  of,  137,  138,  231  ;  re- 
lated to  rheumatic,  231 ;  related 
to  asthmatic,  302,  304. 

Normal  t}Tpe  necessarily  ideal,  28. 

No  two  individuals  alike,  24. 

Norway,  drunkenness  and  idiocy 
in,  124. 

Nursing  of  syphilitic  children,  157. 


OCCASIONAL  debauch,  Dangers  of 
an,  123. 

Offspring,  of  the  immature,  245, 
247,  259  ;  of  the  aged,  257,  259. 

Old  family  characters,  Prepotency 
of,  65. 

Organs  diseased  in  gouty,  224. 

Origin,  of  the  unfit,  2,  21,  141, 
172  ;  of  the  idea  of  demoniacal 
possession,  130;  of  physiog- 
nomy, 280. 

Ova,  in  human  ovaries,  35  ;  con- 
vey acquired  characters,  36. 

PAGET,  Sir  James,  on  hereditary 
disease,  4;  on  cancer,  175,  189, 
191. 

Pangenesis,  Theory  of,  12. 

Parentage,  Immature,  250 ;  Senile, 
256  ;  of  insane,  262  j  of  crimi- 
nals, 262,  291,  300. 

Parents  both  neurotic,  result,  1 08, 
109. 

Paternal  taint,  Gravity  of,  in. 

Pathological  characters,  all  allied, 
48  ;  all  transmutable,  48. 

Percentage,  of  insanity  heredi- 
tary, 91,  100 ;  of  insanity  due 
to  drunkenness,  126;  of  epi- 
lepsy hereditary,  135  ;  of  cancer 
hereditary,  189,  192  ;  of  tuber- 
cular  disease  hereditary,  208  ; 
of  deaths  due  to  tubercle,  194  ; 
of  gout  hereditary,  219;  of 
rheumatism  hereditary,  229 ; 
of  prostitution  in  degenerate 
families,  290. 

Persons  who  should  not  marry,  94. 

Pfitzner  on  atrophy  of  little  toe, 

37- 

Phrenology,  282. 

Phthisical,  The,  diathesis,  198; 
precocious,  199 ;  Marriage  of, 
212  ;  Premature  death  of  chil- 


INDEX. 


323 


dren  of,  199  ;  described,  201  ; 
Treatment  of  children  of,  213. 

Physiognomy,  280;  practised  by 
man  and  animals,  281. 

Plato  on  punishment  of  criminals, 
294. 

Plural  births  hereditary,  63. 

Precautions  against  syphilis,  157* 
against  cancer,  192  ;  against 
tubercular  disease,  210. 

Precocious  criminality,  298. 

Premature  death  of  the  unfit,  1 8, 
61,  97,  102,  109,  125,  137,  140, 
155,  199,  245,  248. 

Premature  marriages,  243  ;  chil- 
dren of,  245,  248. 

Prepotency,  56;  limits  variation, 
27  ;  how  gained,  57.  65  ;  best 
seen  in  physiological  characters, 

60,  63  ;  in  disease,  6l ;  in  gout, 

6 1,  219  ;  a  part  of  evolution, 
65. 

Present  asylum  system  increases 

insanity,  83. 

Prevention  of  insanity,  96. 
Propagation  of  insanity,  85. 
Proportion  of  population  insane, 

83- 

Prostitutes,  tubercular  disease  in, 
208  ;  are  of  degenerate  families, 
290  ;  rank  with  male  petty  cri- 
minal, 290. 

Punishment,  of  drunkards  useless, 
121  ;  of  drunkards  unjust,  122  ; 
useless  against  instinctive  crime, 
295- 

QUACKS  and  syphilis,  158. 
Quain's  "Dictionary  of  Medicine," 

214,  307,.  311. 
Quatrefages,  De,  on  heredity,  33. 

RACIAL  type  preserved  by  heredity, 
n. 


Radcliffe,  Dr.,  on  chorea,  235. 

Recidivist,  examples  of  the  cri- 
minal, 296. 

Records  of  syphilitic  families,  151. 

Registrar- General,  The,  on  suicide, 
87  ;  on  epilepsy,  140  ;  on  cancer, 
J77»  I79>  on  marriage,  252, 
256,  264. 

Relatives  of  the  insane,  93. 

Repeated  transmission  fixes  a 
character,  51. 

Report  of  Commissioners  in  Lun- 
acy, 82. 

Result  of  intermarriage  of  extreme 
varieties,  46. 

Re  version  al  heredity,  72. 

Reversion,  its  use,  44,  54 ;  its 
mode  of  working,  46,  54  ;  in 
gout,  62 ;  prevented  by  bi- 
parental  taint,  108  ;  to  health, 
no  ;  prevented  by  consanguin- 
eous unions,  271. 

Reynolds,  Dr.  J.  Russell,  on  her- 
edity in  epilepsy,  134,  139;  on 
the  unfit,  172. 

Rheumatism,  228 ;  transmutable, 
230 ;  allied  to  other  degenera- 
tions, 231  ;  and  heart-disease, 
238. 

Ribot,  on  transmission  of  acquired 
characters,  66  ;  on  deafmutism, 
I63. 

Richardson,  Dr.  B.  W.,  on  heredi- 
tary disease,  22  ;  on  hereditary 
cancer,  185  ;  on  intermarriage 
of  disease,  241. 

Robbing  the  unborn,  33. 

Roberts,  Sir  F.  T.,  on  gout,  214. 

Rossi,  on  hereditary  crime,  288  ; 
on  parentage  of  crime,  291,  293. 

SAVAGE,  Dr.  G.  H.,  on  diabetes 

and  insanity,  311. 
Scheuerlcn  on  cancer  bacillus,  182. 


324 


INDEX. 


Sciatica,  236. 

Scientific  accuracy  wanting,  in 
physiognomy,  281  ;  in  phren- 
ology, 282. 

Scotch  Lunacy  Commissioners  on 
deaf  mutism,  1 66. 

Scotland,  cancer  in,  179. 

Scrofula,  in  children  of  senile, 
206  ;  in  criminals,  207, 

Scrofulous,  The,  diathesis,  201  ; 
origin  of,  206. 

Scudamore,  Sir  C.,  on  heredity  in 
gout,  219. 

Se*e,  M.,  onchoreaand  rheumatism, 

234- 

Selection  of  husbands  and  wives,  7. 

Self-sacrifice  in  woman,  128. 

Seneca  on  gout  in  Roman  women, 
223. 

Senile,  melancholia  hereditary, 
105  ;  marriage  of  the,  256,  264 ; 
parentage,  206. 

Sexual  atavism,  73. 

Shakespeare,  on  effect  of  repeated 
acts,  42  ;  on  children  of  the  im- 
mature, 249. 

Sichard  on  parentage    of   crime, 

293- 

Silver,  Dr.,  on  diabetes,  311. 

Sheep,  Southdown,  59 ;  Ancon, 
276. 

Social  consanguinity,  272 ;  rare 
in  Jews,  273. 

Spermatozoa,  production  of,  36  ; 
convey  disease,  36. 

Sterility,  among  the  unfit,  17,  31, 
40,  47,  49,  6 1,  1 08  ;  in  the  in- 
sane, 108 ;  in  the  epileptic, 
108  ;  in  the  neurotic,  109,  136  ; 
in  the  drunken,  125;  in  the 
cancerous,  187  ;  in  syphilis, 

145- 

Sterne,  Lawrence,  on  the  begetting 
of  children,  77. 


Stewart,  Dr.,  on  heredity  in  in- 
sanity, 100. 

St.  Vitus's  dance,  234. 

Suicide,  Nature's  remedy,  19,  87  ; 
increase  of,  87 ;  in  children, 
IO2  ;  transmitted,  100  ;  trans- 
mutable,  18,  49,  109,  138  ;  Vol- 
taire on,  101  ;  allied  to  asthma, 
302. 

Superiority  of  mixed  races,  277. 

Sweden,  drunkenness  in,  124 ; 
idiocy  in,  125. 

Syphilis,  143  ;  acquired,  145  ; 
symptoms  of,  146  ;  hereditary, 
149  ;  effect  on  the  degenerate, 
148;  among  the  poor,  154; 
among  savages,  154;  its  source, 
155;  legislation  against,  156; 
in  a  nurse,  158;  and  vaccina- 
tion, 1 58  ;  and  marriage,  1 59  ; 
and  quacks,  158  ;  Treatment  of, 

158. 

Syphilitic,  degeneration,  143 ; 
poison,  144;  children,  150. 

TARNOWSKY,  Dr.  B.,  on  hereditary 
syphilis,  151  ;  Dr.  P.,  on  de- 
generation in  the  prostitute, 
208  ;  on  parentage  of  the  pros- 
titute, 292,  293. 

Teeth  becoming  fewer  in  man,  38. 

Theory  of  Pangenesis,  12. 

Thomson,  Bruce,  207. 

Transmission,  of  acquired  charac- 
ters, 37,  52  ;  of  epilepsy,  40, 
135  ;  of  physical  characters,  71 ; 
of  mental  and  moral  characters, 
74 ;  of  insanity,  92,  IOO,  ill; 
of  cancer,  191  ;  of  gout,  219, 
221  ;  of  crime,  288;  of  haemorr- 
hagic  temperament,  306  ;  of 
colour-blindness,  308  ;  of  cata- 
ract, 310;  of  Bright's  disease, 
312. 


INDEX. 


325 


Transmutability  of  disease  ten- 
dency, 48,  99,  205  ;  of  drink 
crave,  125,  126;  of  epilepsy, 
135,  136 ;  of  the  neuroses  gene- 
rally, 1 8,  137,  138;  of  cancer, 
49,  184;  of  tubercular  diathesis, 
205  ;  of  rheumatism,  230,  236  ; 
of  neuralgia,  236 ;  of  crime, 
290. 

Treatment,  of  syphilis,  1 58  ;  of 
instinctive  criminal,  296,  298, 
300. 

"  Tristram  Shandy,"  cited,  77. 

Tubercle  bacillus,  The,  195  ;  in- 
fection by,  210. 

Tubercular  diathesis,  197  ;  a  de- 
generation, 197,  203  ;  allied  to 
other  degenerations,  197  ;  and 
marriage,  212. 

Tubercular  disease,  194 ;  modes 
of  infection  with,  196,  210  ;  in 
cattle,  210;  in  criminals,  207; 
in  prostitutes,  2oS  ;  attacks  the 
enfeebled,  208  ;  in  captive  wild 
animals,  211  ;  Treatment  of,  in 
children,  213. 

"Tubercular  level,"  209. 

Turner,  Sir  William,  on  trans- 
mission of  acquired  characters, 
36 ;  on  the  modern  American, 
39  ;  on  heredity  in  deafmutism, 
165,  168. 

Type  of  family,  can  be  modified, 
1 6 ;  is  modified  by  environ- 
ment, 28. 

Typical  cases  of  instinctive  crimi- 
nality, 296. 

UGLINESS,  of  congenital  insane, 
287  ;  of  instinctive  criminal, 
287. 

Uncivilised  peoples  more  healthy, 

20. 

Unfit,  The,  the  result  of  civilisa- 


tion, 2  ;  a  drag  on  society,  21  ; 
deliberately  cultivated,  21,  142, 
170  ;  the  result  of  interference 
with  nature,  141. 
Untruth  fulness  of  relatives  of  in- 
sane, 90. 

VACCINATION  and  syphilis,  158. 

Variation,  limited  by  prepotency, 
27  ;  either  physiological  or 
pathological,  28;  produced  by 
environment,  28 ;  causes  of,  32 ; 
when  extreme  dies  out,  45  ; 
intermarriage  of,  46,  47. 

Various,  blendings  of  parental 
characters,  24  ;  estimates  of 
heredity  in  insanity,  91,  100  ; 
estimates  of  heredity  in  epilepsy, 

135- 
Vegetable  food  a  cause  of  gout, 

217. 
Vegetarians,  on  cancer,  180  ;  on 

gout,  215. 

Vigour  of  mixed  races,  278. 
Virchow.Prof.,  on  supposed  cancer 

bacillus,  182. 
Virgilio,  Dr.,  on  parentage  of 

crime,  292. 
Volitional    power    dependent  on 

organisation,  294. 
Voltaire     on     suicidal     instinct, 

101. 

Vulcan's  deformity  the  result  of 
Jupiter's  drunkenness,  123. 

WEBSTER,   Dr.,    on    heredity    in 

epilepsy,  135. 
Weismann,  Prof.,  on  acquired 

characters,   34 ;    his  theory  of 

heredity,  34. 
Wells,  Sir  Spencer,  on  increase  of 

cancer,    178 ;    on    heredity   in 

gout,  221,  227. 


326 


INDEX. 


Wey,  Dr.,  on  disease  in  criminals, 
207  ;  on  causes  of  death  in 
criminals,  286. 

Wife-heroes,  129. 

Wilson,  Dr.  G.,  on  degeneracy  in 
criminals,  285. 

Wines  in  gout,  216. 


Wisdom  teeth  in  civilised  man, 
38. 

Women,  sacrifice  themselves,  128; 
transmit  insanity  with  certainty, 
III,  114;  are  acquiring  new 
diseases,  222;  Increase  of  crime 
among,  290. 


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